Objective To observe the effect of calcified lymph nodes on video-assisted thoracoscopic surgery (VATS) lobectomy in the chronic obstructive pulmonary disease (COPD) patients with lung cancer. Methods A retrospective analysis was conducted on the COPD patients with lung cancer who underwent VATS lobectomy in the Department of Thoracic Surgery in the First Affiliated Hospital of Hebei North University from May 2014 to May 2018.The patients were assigned into a calcified lymph node group and a control group according to the presence or absence of calcified lymph nodes in CT,and the size,morphology,and calcification degree of the lymph nodes were recorded.The operation duration,intraoperative blood loss,chest tube retention time,hospitalization days,and overall complication rate were compared between the two groups. Results The 30 patients in the calcified lymph node group included 17 patients with one calcified lymph node and 13 patients with two or more calcified lymph nodes,and a total of 65 calcified lymph nodes were recorded.The calcified lymph nodes with the size ≤5 mm were the most common (53.8%),and complete calcification was the most common form (55.4%) in lymph node calcification.The mean operation duration had no significant difference between the calcified lymph node group and the control group (t=-1.357,P=0.180).The intraoperative blood loss (t=-2.646,P=0.010),chest tube retention time (t=-2.302,P=0.025),and hospitalization days (t=-2.274,P=0.027) in the calcified lymph node group were higher than those in the control group. Conclusion Calcified lymph nodes increase the difficulty and risk of VATS lobectomy in the COPD patients with lung cancer.The findings of this study are conducive to predicting the perioperative process of VATS lobectomy.
Humans ; Blood Loss, Surgical ; Retrospective Studies ; Lung Neoplasms/surgery* ; Pulmonary Disease, Chronic Obstructive ; Calcinosis ; Lymph Nodes

Objectives:To analyze the allocation of mental health resources in Chinese mainland and the change of these resources during the 13 th Five-year Mental Health Plan period. This analysis will serve as evidence for developing future national mental health prevention and control policies. Methods:The National Mental Health Program Office created one questionnaire to survey available mental health facilities by the end of 2020. Descriptive methods were used to analyze the mental health facilities, psychiatric beds, and mental health professionals from type, sponsor, administrative level, regions, and sub-specialities.Results:By the end of 2020, 5 936 facilities were providing mental health services in Chinese mainland. 798 191 psychiatric beds (5.65 beds/10 000 persons), 50 124 psychiatrists (3.55/100 000 persons), and 139 642 registered nurses (9.89/100 000 persons) were located in these facilities. Of all these 5 936 mental health facilities, 649 (1.09%) had geriatric psychiatric wards, 312 (0.53%) had child psychiatric wards, and 1 548 (26.08%) had rehabilitation departments. 350 counties (12.31%) had no mental health facilities and 883 counties (31.05%) had no psychiatric beds in Chinese mainland, mainly in the mid-western regions. The numbers of psychiatric beds, psychiatrists, and registered nurses per unit land area in the western region were about 4 times lower than those in the middle region and 7-11 times lower than those in the eastern region.Conclusions:The mental health resources in Chinese mainland increased significantly from 2015 to 2020, but there are still the problems of uneven geographical allocation of resources and lagged sub-specialities development. While formulating the construction and development plan for mental health prevention and control system in the future, we should further develop the mental health resources at the county level, and vigorously support to establish of mental health sub-specialities for the elderly and children, as well as mental health rehabilitation, particularly in the mid-western regions.

Objectives:To analyze the allocation of mental health resources in Chinese mainland and the change of these resources during the 13 th Five-year Mental Health Plan period. This analysis will serve as evidence for developing future national mental health prevention and control policies. Methods:The National Mental Health Program Office created one questionnaire to survey available mental health facilities by the end of 2020. Descriptive methods were used to analyze the mental health facilities, psychiatric beds, and mental health professionals from type, sponsor, administrative level, regions, and sub-specialities.Results:By the end of 2020, 5 936 facilities were providing mental health services in Chinese mainland. 798 191 psychiatric beds (5.65 beds/10 000 persons), 50 124 psychiatrists (3.55/100 000 persons), and 139 642 registered nurses (9.89/100 000 persons) were located in these facilities. Of all these 5 936 mental health facilities, 649 (1.09%) had geriatric psychiatric wards, 312 (0.53%) had child psychiatric wards, and 1 548 (26.08%) had rehabilitation departments. 350 counties (12.31%) had no mental health facilities and 883 counties (31.05%) had no psychiatric beds in Chinese mainland, mainly in the mid-western regions. The numbers of psychiatric beds, psychiatrists, and registered nurses per unit land area in the western region were about 4 times lower than those in the middle region and 7-11 times lower than those in the eastern region.Conclusions:The mental health resources in Chinese mainland increased significantly from 2015 to 2020, but there are still the problems of uneven geographical allocation of resources and lagged sub-specialities development. While formulating the construction and development plan for mental health prevention and control system in the future, we should further develop the mental health resources at the county level, and vigorously support to establish of mental health sub-specialities for the elderly and children, as well as mental health rehabilitation, particularly in the mid-western regions.

Background and objective hTe management of pulmonary nodules relies on cancer risk assessment, in which the only widely accepted criterion is diameter. hTe development of volumetric computed tomography (CT) and three-dimensional (3D) sotfware enhances the clarity in displaying the nodules’ characteristics. hTis study evaluated the values of the nodules’ volume and 3D morphological characteristics (edge, shape and location) in cancer risk assessment.Methods hTe CT data of 200 pulmonary nodules were retrospectively evaluated using 3D volumetric sotfware. hTe malignancy or benignity of all the nodules was conifrmed by pathology, histology or follow up (>2 years).Logistic regression analysis was performed to calculate the odds ratios (ORs) of the 3D margin (smooth, lobulated or spiculated/irregular), shape (spherical or non-spherical), location (purely intraparenchymal, juxtavascular or pleural-attached), and nodule volume in cancer risk assessment for total and sub-centimeter nodules. hTe receiver operating characteristic (ROC) curve was employed to determine the opti-mal threshold for the nodule volume.Results Out of 200 pulmonary nodules, 78 were malignant, whereas 122 were benign. hTeLogistic regression analysis showed that the volume (OR=3.3;P<0.001) and the 3D margin (OR=13.4, 9.8; bothP=0.001) were independent predictive factors of malignancy, whereas the location and 3D shape exhibited no total predictive value (P>0.05). ROC analysis showed that the optimal threshold for malignancy was 666 mm3. For sub-centimeter nodules, the 3D margin was the only valuable predictive factor of malignancy (OR=60.5, 75.0;P=0.003, 0.007).Conclusion hTe volume and 3D margin are important factors considered to assess the cancer risk of pulmonary nodules. Volumes larger than 666 mm3 can be determined as high risk for pulmonary nodules; by contrast, nodules with lobulated, spiculated, or irregular margin present a high malignancy probability.

Objective:To investigate the improved superantigen activity of SEC2(T20L/G22E) compared with recombinant staphylococcal enterotoxins C 2 ( rSEC2 ).Methods: The proliferation of spleen lymphocytes and T-cell subpopulations induced by rSEC2 and SEC2(T20L/G22E) were examined by WST-1 and flow cytometry separately,and the gene expression of cytokines and Vβspecificities were quantified by real-time PCR.Results: WST-1 and Flow cytometry assays showed that the superantigen activity of SEC2(T20L/G22E) was improved due to enhanced T-cell stimulating potency,resulting in massive activation of T-cells,particularly CD4+and CD8+T-cells.Quantitative real-time PCR assay showed that despite similar Vβspecificities induced by rSEC 2 and SEC2 (T20L/G22E),the quantities of activated T-cells bearing specific Vβwere different,and SEC2(T20L/G22E) could stimulate more gene expression of associated cytokines simultaneously.Conclusion: The results strongly suggested that the increased SEC 2 ( T20L/G22 E)-TCR-binding affinity contributed to more T-cells activation and cytokine release ,which elicit powerful immune activition.

Objective To study the value of SCCAg,CYFRA21-1 and TPS in the diagnosis and prognostic evaluation of patients with cell cervical cancer (SCC).Methods The levels of serum SCCAg,CYFRA21-1and TPS from 160 SCC patients and 60 health women were detected by means of ELISA.Results ( 1 ) The levels of serum SCCAg,CYFRA21-1and TPS in SCC were significantly higher than those of normal group ( P ＜0.001 ).The median values of normal group:0.43 μg/L,0.43 μg/L,26 U/L,the median values of cervical cancer group:1.96 μg/L,2.29 μg/L,149.1 U/L ( 2 ) The specificity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC were both 100％.The sensitivity of SCCAg,CYFRA21-1 and TPS in diagnosing SCC was 53.42％,40.68％ and 83.95％,respectively.The sensitivity of TPS was obviously different from SCCAg and CYFRA21-1 ( P ＜0.001 ).The sensitivity of SCCAg plus CYFRA21-1 and three markers together were 69.23％and 92.31％,respectively.(3)The expressing of SCCAg,CYFRA21 -1 and TPS in FIGO stages Ⅲ plus Ⅳ was significantly higher than in stages Ⅰ plus Ⅱ (P ＜ 0.05 ),and all markers were not related to the degree of histological differentiation.SCCAg was correlated strongly with tumor size,growth type,lymph node metastasis and age( P ＜ 0.05 ),but CYFRA21-1 was not correlated with all these factors.TPS level was significantly associated with tumor size and lymph node metastasis( P ＜0.05 ),but not with growth type and age.(4)A total of 78 patients were followed up.The pretreatmental serum levels of SCCAg and CYFRA21-1 in patients with recurrence were significantly higher than those without recurrence( P ＜0.05 ).The same trend was not found for TPS.Compared with the normal control,the patients with elevated SCCAg before treatment has shorter intervals before recurrence and metastasis occurred.Also,the survival of patients with elevated SCCAg before treatment was shorter than the normal control ( P ＜ 0.05 ).Conclusion SCCAg,CYFRA21-1 and TPS serum levels are valuable markers for the diagnosis of SCC.Meanwhile,SCCAg and CYFRA21-1 are chnically significant pridictors for the prognosis of SCC.

The morbidity and mortality of malignant tumor is increasing in our country.It is crucial to enhance the clinical oncology education.We set the clinical oncology class for the medical university students and obtained good teaching effect by enhancing cognition,selecting the proper teaching content,making reasonable teaching program and using multiple teaching style.

Objective To explore the expression of Ezrin in hepatocellular carcinoma(HCC),and the relation of Ezrin expression to E-cadherin,proliferating cell nuclear antigen(PCNA) and clinical features of HCC.Methods Forty-nine cases of HCC were divided into high and low invasive groups according to tumor size,disseminated lesions,distant metastasis,tumor capsule and portal vein tumor thrombus.The expression of Ezrin,E-cadherin and PCNA in normal liver tissues,HCC and adjacent tissues were determined by immunohistochemistry,and the relation of the expression to clinical features was analyzed.Results The Ezrin expression was found in normal liver tissues,HCC and adjacent tissues,and was significantly higher in HCC tissues than in adjacent and normal liver tissues(P