Objective To develop and validate a model to predict the risk of radiation-induced lung injury (RILI) and assess its clinical feasibility. Methods Clinical data from 125 patients with non-small cell lung cancer (NSCLC) were included in the study. The patients were divided into training group (88 cases) and validation group (38 cases). Key predictive factors were identified using univariate and multivariate logistic regression analyses combined with least absolute shrinkage and selection operator (LASSO) regression. A predictive model was constructed and evaluated using a nomogram, receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis. Results The key variables identified by the model were tumor volume (P = 0.017), Eastern Cooperative Oncology Group performance status score (P = 0.035), 95% of the minimum dose to the target volume (P = 0.028), percentage of bilateral lung volume receiving 20 Gy of radiation (P < 0.001), and neutrophil-to-lymphocyte ratio (P = 0.021). The ROC curve showed that the areas under the curve (AUC) for the model in the training and validation groups were 0.987 and 0.992, respectively, indicating good predictive ability. The calibration curve and decision curve further confirmed the accuracy and clinical practicability of the model. Conclusion The predictive model proposed in this study can accurately assess the risk of developing RILI in patients with NSCLC who have undergone radiotherapy, demonstrating its potential value in clinical practice.

Objective:To explore the spatial and temporal distribution patterns of emerging snail-infested sites in different environmental types in Yunnan Province.Methods:The data of snail-infested sites in Yunnan Province from 1950 to 2014 (from Yunnan Institute for Endemic Diseases Control and Prevention), were collected and sorted out, a spatial and temporal database on the distribution of emerging snail-infested sites were established, and the changes in the spatial and temporal distribution of emerging snail-infested sites in different environments types (ditches, tangerines, paddy fields, dry land, beaches and other environments) were studied by using spatial autocorrelation analysis and scanning statistics analysis.Results:From 1950 to 2014, the annual number of emerging snail-infested sites in Yunnan Province reached a peak (1 730) in 1955 and then showed a fluctuating downward trend. From 1993 to 2014, the number of emerging snail-infested sites remained below 100, and increased to 160 and 131, respectively, in 2004 and 2013. The longest mean duration of 43.85 years was recorded for the beaches environment for emerging snail-infested sites, followed by the paddy fields environment with a mean duration of 37.01 years, and the shortest mean duration of 20.44 years for the tangerines environment. Spatial autocorrelation analysis showed that there was a positive spatial correlation between the duration of emerging snail-infested sites of different environmental types (global Moran's I ranged from 0.43 to 0.64, P < 0.05). Scanning statistics analysis showed that emerging snail-infested sites of different environmental types had spatial and temporal aggregation ( P < 0.001), with 3- 6 clusters of statistically significant aggregation detected respectively. Conclusion:The emerging snail-infested sites in different environments types in Yunnan Province have spatial and temporal aggregation, and it is necessary to strengthen monitoring and prevention and control of the aggregation areas of different environment types to prevent further spread of the snail.

BACKGROUND: Lung cancer is the first leading cause of morbidity and mortality among the malignant tumors, which has become a hot issue in current research. Clinically, lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to the pathological types. NSCLC includes adenocarcinoma, squamous cell carcinoma and other types of lung cancer, accounting for about 80% of all lung cancer. Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE), which is a recognized complication in lung cancer patients with higher morbidity and mortality. The aim of this study is to determine the incidence of DVT and reveal the risk factors for DVT in the postoperative patients with lung cancer. METHODS: We collected 83 postoperative patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from December 2021 to December 2022. All these patients were examined by color Doppler ultrasound of lower extremity vein upon admission and after operation to analyze the incidence of DVT. In order to explore the possible risk factors for DVT in these patients, we further analyzed the correlations between DVT and their clinical features. At the same time, the changes of coagulation function and platelet were monitored to investigate the value of blood coagulation in the patients with DVT. RESULTS: DVT occurred in 25 patients after lung cancer operation, and the incidence rate of DVT was 30.1%. Further analysis found that the incidences of postoperative lower limb DVT were higher in lung cancer patients of stage III+IV or over 60 years of age (P=0.031, P=0.028). D-Dimer level in patients with thrombosis was significantly higher than that in non-thrombus patients on the 1st, the 3rd, and the 5th day after operation (P<0.05), and there was no significant difference in platelets and fibrinogen (FIB) (P>0.05). CONCLUSIONS The overall incidence of DVT in our center after lung cancer patients operation was 30.1%. Late-stage and older postpatients were more likely to develop DVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.
Humans ; Middle Aged ; Aged ; Lung Neoplasms/surgery* ; Incidence ; Carcinoma, Non-Small-Cell Lung ; Venous Thromboembolism ; Venous Thrombosis/etiology*

Osteoporotic vertebral compression fracture (OVCF) can lead to lower back pain and may be even accompanied by scoliosis, neurological dysfunction and other complications, which will affect the daily activities and life quality of patients. Vertebral augmentation is an effective treatment method for OVCF, but it cannot correct unbalance of bone metabolism or improve the osteoporotic status, causing complications like lower back pain, limited spinal activities and vertebral refracture. The post-operative systematic and standardized rehabilitation treatments can improve curative effect and therapeutic efficacy of anti-osteoporosis, reduce risk of vertebral refracture, increase patient compliance and improve quality of life. Since there still lack relevant clinical treatment guidelines for postoperative rehabilitation treatments following vertebral augmentation for OVCF, the current treatments are varied with uneven therapeutic effect. In order to standardize the postoperative rehabilitation treatment, the Spine Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized relevant experts to refer to relevant literature and develop the "Guideline for postoperative rehabilitation treatment following vertebral augmentation for osteoporotic vertebral compression fracture (2022 version)" based on the clinical guidelines published by the American Academy of Orthopedic Surgeons (AAOS) as well as on the principles of scientificity, practicality and advancement. The guideline provided evidence-based recommendations on 10 important issues related to postoperative rehabilitation treatments of OVCF.

Systemic sclerosis (SSc) is an autoimmune disease with unknown etiology, characterized by vasculopathy, inflammation, and extensive fibrosis in the skin and organs. Fibrosis is the hallmark of SSc and contributes to its high mortality. In recent years, with the in-depth study of the epigenetics of SSc (DNA methylation, histone modification, and non-coding RNA), the DNA methylation and miRNA has been the most widely studied. Abnormal DNA methylation can influence the function of vascular endothelial cells, CD4+ T cells, and fibroblasts in SSc. MiRNAs in serum is closely related to autoantibodies, SSc disease activity and complications, and miRNAs in fibroblasts can directly affect the activation of fibroblasts.
DNA Methylation ; Epigenesis, Genetic ; Epigenomics ; Fibroblasts ; Fibrosis ; Humans ; Research ; trends ; Scleroderma, Systemic

BACKGROUND: Venous thromboembolism (VTE) is a recognized complication in lung cancer patients with higher morbidity and mortality. The purpose of this study is to determine the incidence of lower extremity venous thrombosis (LEDVT) in lung cancer patients and to reveal the risk factors for LEDVT during admission in our center. METHODS: We first connected 231 patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from July 2017 to December 2017. All these patients underwent color ultrasound examination of lower extremity vein on admission to analyze the incidence of LEDVT. At the same time, the incidence of LEDVT in patients with benign lung diseases on admission was used as control. In order to explore the possible risk factors for LEDVT in these patients with lung cancer, we further analyze the correlations between LEDVT and their clinical features. At the same time, we also analyze the relationship between LEDVT and Plasma D-Dimmer, fibrinogen (FIB), thrombin time (TT), activated partial thrombin time (APTT), prothrombin time (PT) and platelet (PLT) in these patients with lung cancer. RESULTS: Among 231 patients with lung cancer, the incidence rate of LEDVT on admission was 5.2% (12/231), and in 77 patients with benign lung disease, there was none of patients with LEDVT on admission. This result indicated that the admitted incidence rate of LEDVT in patients with lung cancer was significantly higher than that in patients with benign lung disease (P<0.05). Further analysis in patients with lung cancer found that there was higher incidence rate of LEDVT in distant metastasis group (including N3 lymph node metastasis) compared to in non-distant metastasis group (11.29%, 7/62 vs 2.96%, 5/169) (P<0.05). In patients with lung cancer, the median value of D-Dimer in LEDVT group was 1,534 mg/L (369 mg/L-10,000 mg/L), which was significantly higher than that in the non-LEDVT group (539 mg/L, 126 mg/L-1,000 mg/L) (P<0.05). There was no statistically significant difference in FIB, TT, APTT, PT and PLT between these two groups (P>0.05). CONCLUSIONS The overall incidence of LEDVT in our central lung cancer patients was approximately 5%, significantly higher than that in patients with benign lung disease. Lung cancer patients with distant metastasis (including N3 lymph node metastasis) at admission were more likely to develop LEDVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.
Female ; Humans ; Incidence ; Lower Extremity ; Lung Neoplasms ; surgery ; therapy ; Male ; Middle Aged ; Patient Admission ; Risk Factors ; Tomography, X-Ray Computed ; Venous Thrombosis ; diagnostic imaging ; etiology

Objective In order to play the role of pathological network management system better in pathological examination, this study explore the present status of new pathology network management system, give an objective evaluation for the operation condition, reveal the effectiveness and the existing problems of this system, and provide reference for its development and improvement.Methods The software of pathological network management system was applied to the pathological specimen reception, patient information and examination status query, pathological diagnosis and technology process, as well as the paraffin block archive, statistical analysis, data recording, and so on.At last, we recorded all the information and made a classification and arrangement.Results Pathological network management system was running normally through the whole process of pathologic examination, including specimen receiving, all examinations, print of pathological applications and spontaneous print of pathological reports in ward, which really achieve one-stop services.But the system has unstable phenomenon occasionally.Conclusion Pathological network management system links each examination process closely, which can improve the work efficiency, and provide scientific basis for pathology quality control.

Objective MicroRNAs (miRNAs) are of important clinical value in various tumors.However, few studies are reported about their role in thymic epithelial tumors.This article aims to explore differential expression profile of miRNAs in type B3 thymoma and thymic carcinoma.Methods This study included the pathological data about 45 cases of type B3 thymoma and thymic carcinoma surgically treated in our hospital from January 2012 to January 2015, of which 3 cases of type B3 thymoma (control group) and another 3 cases of thymic carcinoma (case group) were subjected to miRNA microarray for determination of the differential expressions of miRNAs in the tumor tissues.The up-and down-regulated miRNAs were calculated, their target genes were predicted via online databases, and the thymus-related genes were identified.Results Totally, 32 differentially expressed miRNAs (including miR-125b-1-3p, miR-3175, and miR-4462) were up-regulated and another 19 (including miR-361-5p, miR-130a-3p, and miR-3651) down-regulated in thymic carcinoma.AKT1, C9, CD19, CDC42, LSS, and MYC were identified as the target genes of miR-377-5p, ADCYAP1R1, ASPA, CAD, and CD63 as the target genes of miR-458-5p, and AKAP12, CD28, FOXP1, and MDM4 as the target genes of miR-183-5p.Conclusion Differentially expressed miRNAs were identified in type B3 thymoma and thymic carcinoma and their target genes predicted using the prediction software, which may provide some valid evidence for further study of thymic epithelial tumors.

Objective To explore the relationship between the level of plasma ADAMTS4 and the vulnerability of carotid atherosclerotic plaque in patients with carotid artery stenosis and the clinical value of evaluating the vulnerability of the carotid atherosclerotic plaque.Methods 60 patients with carotid artery stenosis were divided into stable plaque group and vulnerable plaque group according to the histopathological typing after carotid endarterectomy (CEA).30 patients who had atherosclerosis but no carotid plaque formation served as control.Using ELISA to measure the level of plasma ADAMTS4.Results The level of plasma ADAMTS4 was significantly higher in the vulnerable-plaque group (112.74 ± 17.47) ng/ml compared with the stable plaque group (56.67 ± 22.14)ng/ml and the control group (56.67 ± 22.14)ng/ ml,P ＜ 0.001.Logistic analysis showed that high level of plasma ADAMTS4 was risk factor for vulnerability of carotid atherosclerotic plaque (P ＜ 0.05,OR =8.240,95 ％ CI:1.512-22.915).ROC curve showed that ADAMTS4 =100.935 ng/ml could accurately predict significant vulnerability with accuracy of 94.3％.Conclusion ADAMTS4 is an effective,sensitive and non-invasive biomarker to evaluate the vulnerability of carotid atherosclerotic plaque.

Objective When pathologists from hospitals at various levels encounters pathological sections diffcult to make clear diagosis, it is necessary to invite pathologists from higher hosiptals or special hospitals for pathologic consultation.In the study, we compared the pathological diagnosis of cases sent to other hospitals for pathological consultation with the original diagnostic result to analyze the differences by the evaluation on the impact of these differences on the treatment and prognosis of these patients, which would provide an effective evidence for the quality control of pathological diagnosis. Methods Cases initially diagnosed at the de-partment of Nanjing General Hospital and later sent to other hospitals for pathological consultation from 2010 to 2014 were collected. All the diagnostic results were examined by at least 3 senior pathologists to find exact diffrences between consultation results and origi-nal diagnostic results. Results Among 2055 cases, it was found that there were 1813 cases (88.2%) without diagnostic discrepan-cy, while 218 cases (10.6%) with minor diagnostic discrepancy and 24 cases (1.2%) with completely distinct diagnostic results. Conclusion The diagnostic results of the vast majority of consultation cases are in accordance with the original results, despite of di-agnostic discrepancies in some cases due to the complexity of disease. Expert consultation has reference for the pathological diagnosis of complicated cases, which also plays a potent supervisory role on the quality control of original pathologic results.