Objective To compare the long-term prognosis of elderly patients with stageⅠnon-small cell lung cancer (NSCLC) after lobectomy or segmentectomy. Methods Data of elderly patients with stageⅠNSCLC between 2010 and 2020 were collected from the SEER database. According to the resection method, patients were divided into a lobectomy group and a segmentectomy group. The overall survival (OS) and lung cancer-specific survival (LCSS) of the two groups were compared by propensity score matching (lobectomy : segmentectomy=2 : 1). Results A total of 9990 patients were included, including 5840 (58.46%) females and 4150 (41.54%) males, with an average age of (70.48±6.47) years. Among them, 9029 patients were in the lobectomy group and 961 patients were in the segmentectomy group. After propensity score matching, a total of 2883 patients were matched, including 1 922 patients in the lobectomy group and 961 patients in the segmentectomy group. There was no statistical difference in baseline data between the two groups (P>0.05). The 10-year OS rate and LCSS rate of the lobectomy group were higher than those of the segmentectomy group (OS: 51.15% vs. 38.35%, P<0.01; LCSS: 79.68% vs. 71.52%, P<0.01). Subgroup analysis showed that the survival advantage of lobectomy was found in patients aged 60-<70 years and ≥80 years; for patients 70-<80 years, there was no statistical difference in OS or LCSS between the two surgical methods (P>0.05). In addition, for patients with tumor diameter ≤2 cm (stages ⅠA1-ⅠA2), lymph node dissection number≥10, and receiving adjuvant radiotherapy/chemotherapy, segmentectomy could also achieve a similar prognosis as lobectomy. Conclusion Overall, for elderly patients with stage ⅠNSCLC, lobectomy can achieve better OS and LCSS. However, individual differences, tumor characteristics, and perioperative treatment plans should be considered comprehensively to determine the surgical method for elderly patients with stageⅠNSCLC.

Objective To conduct a comparative study on the biomechanical performance of using sutures for repairing inferior pole patellar fractures.Methods Compared to the normal patellar structure(Group A),four repair methods,namely,'Krackow'suture(Group B),"Kessler"fixation(Group C),'8-figure'mesh method(Group D),and modified suture bridge(Group E)were adopted.The static stiffness and dynamic stability of inferior pole patellar fractures fixed by each repair method were measured at 30°,60°,and 90° knee flexion.Results The stiffness at all flexion angles in Group E was closer to that in Group A,compared to other repair groups,followed by Group B,then Group D,and finally Group C.After the first cycle,at 30° knee flexion,Group C showed the greatest displacement,while Groups B and E had slightly larger displacements than the Group A,and the displacement of Group D was smaller than that of Group A.At 60° and 90° knee flexion,the displacement in all repair groups was smaller than that of Group A.After 200 cycles in the subsequent three cycles,displacement changes in all repair groups were smaller than those in Group A.Conclusions All repair methods were effective.In terms of biomechanical fixation performance,the modified suture bridge was superior to the'Krackow'suture and'8-figure'mesh,with Kessler fixation being the least effective.However,factors such as the injury severity,incision location,and surgical time should be comprehensively considered in actual clinical use,and it is recommended that the repair method should be selected in the following order:E,B,D,and C.

Objective To conduct a comparative study on the biomechanical performance of using sutures for repairing inferior pole patellar fractures.Methods Compared to the normal patellar structure(Group A),four repair methods,namely,'Krackow'suture(Group B),"Kessler"fixation(Group C),'8-figure'mesh method(Group D),and modified suture bridge(Group E)were adopted.The static stiffness and dynamic stability of inferior pole patellar fractures fixed by each repair method were measured at 30°,60°,and 90° knee flexion.Results The stiffness at all flexion angles in Group E was closer to that in Group A,compared to other repair groups,followed by Group B,then Group D,and finally Group C.After the first cycle,at 30° knee flexion,Group C showed the greatest displacement,while Groups B and E had slightly larger displacements than the Group A,and the displacement of Group D was smaller than that of Group A.At 60° and 90° knee flexion,the displacement in all repair groups was smaller than that of Group A.After 200 cycles in the subsequent three cycles,displacement changes in all repair groups were smaller than those in Group A.Conclusions All repair methods were effective.In terms of biomechanical fixation performance,the modified suture bridge was superior to the'Krackow'suture and'8-figure'mesh,with Kessler fixation being the least effective.However,factors such as the injury severity,incision location,and surgical time should be comprehensively considered in actual clinical use,and it is recommended that the repair method should be selected in the following order:E,B,D,and C.

Objective To explore the key genes of nonalcoholic fatty liver disease(NAFLD),construct and verify the risk predic-tion model of NAFLD disease process Methods Based on the existing genomic microarray data for NAFLD from the GEO database,utili-zing differential expression gene analysis,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis,protein-protein interaction(PPI)network analysis,and machine learning-based feature selection methods,key genes involved in the progression of NAFLD were identified,and a risk prediction model for the progression from simple steatosis(SS)to nonalcoholic steatohepatitis(NASH)was developed.Validation of these key genes was performed through molecular biology experiments in vitro.Results The re-sults of differential expression gene analysis in GEO database showed that there were 1247differential expression genes between the normal control(NC)group and the NASH group,1088differential expression genes between the NC group and the SS group,and 75differential expression genes between the SS group and NASH group.KEGG pathway enrichment analysis,informed by previous studies and litera-ture,identified 4 common signaling pathways related to NAFLD:cholesterol metabolism(hsa04979),galactose metabolism(hsa00052),PI3K/Akt signaling pathway(hsa04151),and PPAR signaling pathway(hsa03320).Using three distinct machine learning-based fea-ture selection methods,4 common genes were pinpointed:AKR1B10,COL1A2,HKDC1 and LAMC3.Molecular biology experiments in vitro showed that AKR1B10 and COL1A2 were significantly up-regulated in NAFLD,which was consistent with the bioinformatics analy-sis results.Conclusion This study identified key genes associated with the progression from SS to NASH and developed a risk prediction model for NAFLD disease progression.These findings offer valuable methods and technologies for the effective control,intervention,and clinical diagnosis and treatment of NAFLD.

Objective To explore the key genes of nonalcoholic fatty liver disease(NAFLD),construct and verify the risk predic-tion model of NAFLD disease process Methods Based on the existing genomic microarray data for NAFLD from the GEO database,utili-zing differential expression gene analysis,Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis,protein-protein interaction(PPI)network analysis,and machine learning-based feature selection methods,key genes involved in the progression of NAFLD were identified,and a risk prediction model for the progression from simple steatosis(SS)to nonalcoholic steatohepatitis(NASH)was developed.Validation of these key genes was performed through molecular biology experiments in vitro.Results The re-sults of differential expression gene analysis in GEO database showed that there were 1247differential expression genes between the normal control(NC)group and the NASH group,1088differential expression genes between the NC group and the SS group,and 75differential expression genes between the SS group and NASH group.KEGG pathway enrichment analysis,informed by previous studies and litera-ture,identified 4 common signaling pathways related to NAFLD:cholesterol metabolism(hsa04979),galactose metabolism(hsa00052),PI3K/Akt signaling pathway(hsa04151),and PPAR signaling pathway(hsa03320).Using three distinct machine learning-based fea-ture selection methods,4 common genes were pinpointed:AKR1B10,COL1A2,HKDC1 and LAMC3.Molecular biology experiments in vitro showed that AKR1B10 and COL1A2 were significantly up-regulated in NAFLD,which was consistent with the bioinformatics analy-sis results.Conclusion This study identified key genes associated with the progression from SS to NASH and developed a risk prediction model for NAFLD disease progression.These findings offer valuable methods and technologies for the effective control,intervention,and clinical diagnosis and treatment of NAFLD.

Objective To provide a reliable and stable animal model for investigating the molecular pathogenesis of radiation-induced liver disease (RILD). Methods Ninety C57BL/6J mice were divided into control, 20 Gy, 25 Gy, 30 Gy and 35 Gy radiation groups. The mice were executed at 4 weeks after radiation and the levels of alanine aminotransferase, aspartate aminotransferase, and alkaline phosphatase in the liver serum were measured. HE staining was performed on the pathological liver tissues. Masson staining was performed at 36 weeks after radiation. Results Compared with the control group, the fatality rate was higher in the 30 and 35 Gy radiation groups, and the body weight significantly decreased in the 20 and 25 Gy radiation groups. Compared with the control group, alanine aminotransferase significantly increased in mice exposed to 20 Gy, while aspartate aminotransferase and alanine aminotransferase increased in mice exposed to 25 Gy. No significant changes were observed in the livers of the mice in the 20 and 25 Gy radiation groups, but pathological examination showed liver damage induced by both 20 and 25 Gy radiation. Conclusion A stable and reliable mouse model of RILD was constructed for treatment with linear accelerator. The mouse model of RILD constructed for stereotactic body radiation therapy using linear accelerator has significant research implications for the exploration of RILD.

The accurate annotation of transcription start sites(TSSs)and their usage are critical for the mechanistic understanding of gene regulation in different biological contexts.To fulfill this,specific high-throughput experimental technologies have been developed to capture TSSs in a genome-wide manner,and various computational tools have also been developed for in silico pre-diction of TSSs solely based on genomic sequences.Most of these computational tools cast the problem as a binary classification task on a balanced dataset,thus resulting in drastic false positive predictions when applied on the genome scale.Here,we present DeeReCT-TSS,a deep learning-based method that is capable of identifying TSSs across the whole genome based on both DNA sequence and conventional RNA sequencing data.We show that by effectively incorporating these two sources of information,DeeReCT-TSS significantly outperforms other solely sequence-based methods on the precise annotation of TSSs used in different cell types.Furthermore,we develop a meta-learning-based extension for simultaneous TSS annotations on 10 cell types,which enables the identification of cell type-specific TSSs.Finally,we demonstrate the high precision of DeeReCT-TSS on two independent datasets by correlating our predicted TSSs with experimentally defined TSS chromatin states.The source code for DeeReCT-TSS is available at https://github.-com/JoshuaChou2018/DeeReCT-TSS_release and https://ngdc.cncb.ac.cn/biocode/tools/BT007316.

Background: Laterally spreading tumor (LST) is one of the commonly seen neoplastic lesions under colonoscopy. The risk of malignant transformation is considerably high. Aims: To compare the efficacy and safety of endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) for treatment of colorectal LST. Methods: Eighty-eight patients with colorectal LST were randomly divided into two groups and received EMR and ESD treatment, respectively, from Oct. 2016 to Dec. 2018 at the Baoshan Hospital of Integrated Traditional Chinese and Western Medicine. For LST larger than 20 mm in diameter in EMR group, piecemeal EMR was recommended. The procedure time, complications, en bloc resection rate and recurrence rate during 1-year follow-up were compared between the two groups. Results: All patients enrolled in this study achieved a complete resection. The procedure time of EMR was shorter than that of ESD [(23.73±6.19) min vs.(65.13±13.76) min], and the en bloc resection rate was higher (97.7% vs. 59.1%) and the recurrence rate was lower (11.4% vs. 31.8%) in ESD group than in EMR group (P<0.05). There were no significant differences in perforation and post-procedure bleeding rates between the two groups (P>0.05). In EMR group, the majority of recurrence occurred in cases with LST larger than 20 mm in diameter. Conclusions: For colorectal LST, the method of endoscopic treatment should be selected based on patients' clinical condition. Although the procedure time of EMR is shorter, ESD is more suitable for lesions larger than 20 mm in diameter.

Objective: To evaluate the protective effects of ulinastatin combined with lung-protective ventilation on lungs in patients undergoing laparoscopic colorectal carcinoma surgery. Methods: A total of 120 patients undergoing laparoscopic radical resection of colorectal cancer in Yuncheng Central Hospital were selected in this study.According to thedigital table, they were randomly divided into conventional mechanical ventilation group(G0 group), lung protection mechanical ventilation group(G1 group), conventional mechanical ventilation combined with ulinastatin group(G2 group)and lung protection mechanical ventilation combined with ulinastatin group(G3 group), with 30 cases in each group.Ulinastatin 2 500IU was intravenously infused 10min before induction of anesthesia in G2 group and G3 group.Ventilator parameters were set as tidal volume(V_T)10mL/kg, respiratory frequency 12 times/min, inspiration-expiration ratio(I∶E)1∶2 in G0 group and G2 group.V_T 6mL/kg in G1 group and G3 group , positive end-expiratory pressure ventilation(PEEP)5-10cmH₂O, respiratory frequency 12-18 times/min, once every 30min.Before anesthesia induction(T₀), before pneumoperitoneum(T₁), 2h after pneumoperitoneum(T₂), before extubation(T₃), 24h after operation(T₄), arterial blood was collected to detect partial pressure of oxygen(PaO₂), oxygenation index(OI). And mean airway pressure(Pmean), peak airway pressure(Ppeak)at T_1-3 were recorded.Venous blood was collected at T₀, T₃ and T₄ to detect serum concentrations of interleukin-6(IL-6), interleukin-8(IL-8)and tumor necrosis factor-alpha(TNF-α). Results: At T₃, the PaO₂ of G1 group, G2 group and G3 group were (457±60)mmHg, (460±49)mmHg and (510±45)mmHg, respectively.At T₄, the PaO₂ of the three groups were (90±6)mmHg, (92±7)mmHg and (96±7)mmHg, respectively.The PaO₂ in G1 group and G2 group were lower thanthose in G3 group at T_3-4(t=3.872, 3.850, 4.186, 2.513, all P<0.05). At T₂, the OI of the three groups were (460±44), (462±37) and (481±31), respectively.At T₃, the OI of the three groups were (460±51), (475±62) and (504±38), respectively.The OI in G1 group and G2 group were lower than those in group G3 at T_2-3(t=2.142, 3.753, 2.209, 2.170, all P<0.05). At T₂, the Pmean of G1 group, G2 group and G3 group were (10.5±1.5)cmH₂O, (11.2±1.9)cmH₂O and (9.5±0.9)cmH₂O, respectively, the Ppeak of the three groups were (22.3±3.0)cmH₂O, (24.0±3.3)cmH₂O and (22.3±2.9)cmH₂O, respectively.At T₃, the Pmean of the three groups were (10.9±1.1)cmH₂O, (11.1±1.8)cmH₂O and (9.8±0.9)cmH₂O, respectively, the Ppeak of the three groups were (22.8±2.7)cmH₂O, (24.1±2.1)cmH₂O and (21.6±2.0)cmH₂O, respectively.The Pmean in G1 group and G2 group at T_2-3 were lower than those in G3 group(t=3.061, 4.580, 5.759, 4.305, 3.746, all P<0.05), the Ppeak in G2 group at T_2-3 were lower than those in G3 group(t=2.952, 4.630, all P<0.05). At T₄, the serum concentrations of IL-6 of G1 group, G2 group and G3 group were (151±28)ng/L, (152±20)ng/L and (136±18)ng/L, respectively, the IL-8 levels of the three groups were (468±28)ng/L, (359±65)ng/L and (327±51)ng/L, respectively, the TNF-α levels of the three groups were (1.09±0.20)ng/L, (1.08±0.20)ng/L and (0.94±0.20)ng/L, respectively.The concentrations of IL-6, IL-8 and TNF-α at T₄ in G1 group and G2 group were higher than those in G3 group(t=2.428, 4.094, 2.536, 4.251, 2.807, 3.128, 4.119, 2.592, 3.446, 2.555, all P<0.05). Conclusion The combination of ulinastatin and lung-protective ventilation provides protective effects on lungs and exerts better efficacy than either alone.

Objective:To research the clinical effect of abdominal total hysterectomy on the patients with uterine fibroids and the serum vascular endothelial growth factor (VEGF) and interleukin 6 (IL-6),interleukin 8 (IL-8) levels.Methods:106 cases of patients with uterine fibroids from February 2014 to February 2016 were divided into the control group and the research group according to the lottery method,the control group was treated with total abdominal hysterectomy,while the research group was given abdominal total hysterectomy treatment,the operation time,blood loss,anal exhaust time,length of hospital stay,changes of serum VEGF,IL-6,IL-8,Follicle stimulating hormone (FSH),estradiol (E2) levels,resistance to seedling le tube hormone (AMH) before and after the surgery as well as the occurrence of complications were compared between two groups.Results:The operation time,blood loss,length of hospital stay,anal exhaust time of research group were significantly shorter than those of the control group (P＜0.05).Before surgery,the serum levels of VEGF,IL-6,IL-8,FSH,E2,AMH showed no difference between two groups (P＞0.05).After the operation,the serum levels of IL-6,IL-8,E2,AMH of research group were lower than those of the control group (P＜0.05),the serum level of FSH in research group was higher than that of the control group (P＜0.05).The serum level of VEGF showed no difference between the two groups (P＞0.05).The incidence rate of complications in research group was lower than that of the control group (P＜0.05).Conclusion:Abdominal total hysterectomy showed similar effect with the abdominal hysterectomy in the treatment of uterine fibroids patients,but the abdominal full hysterectomy induced less trauma,promoted the recovery of ovarian function after surgery,which might be related to the decrease of serum IL-6,IL-8 and VEGF levels.