Objective To compare the prognostic differences between simple and complex segmentectomies. Methods We conducted a retrospective cohort analysis of patients with solid pulmonary nodules (≤2 cm) who underwent segmentectomy. Recurrence-free survival (RFS) and local recurrence rates were evaluated. Results We included57 patients undergoing complex segmentectomy and 53 patients undergoing simple segmentectomy. Among patients who did not receive adjuvant therapy, those in the complex group had a significantly lower five-year RFS than those in the simple group (69.86% vs. 85.97%, P=0.04). Furthermore, the local recurrence rate was significantly higher in the complex group (18.75% vs. 4.65%, P=0.003) than in the simple group. Conclusion For solid pulmonary nodules (≤2 cm), complex segmentectomy is associated with inferior local control and worse RFS than simple segmentectomy.

A U-Net incorporating improved Transformer and convolutional channel attention module is designed for biventricular segmentation in MRI image.By replacing the high-level convolution of U-Net with the improved Transformer,the global feature information can be effectively extracted to cope with the challenge of poor segmentation performance due to the complex morphological variation of the right ventricle.The improved Transformer incorporates a fixed window attention for position localization in the self-attention module,and aggregates the output feature map for reducing the feature map size;and the network learning capability is improved by increasing network depth through the adjustment of multilayer perceptron.To solve the problem of unsatisfactory segmentation performance caused by blurred tissue edges,a feature aggregation module is used for the fusion of multi-level underlying features,and a convolutional channel attention module is adopted to rescale the underlying features to achieve adaptive learning of feature weights.In addition,a plug-and-play feature enhancement module is integrated to improve the segmentation performance which is affected by feature loss due to channel decay in the codec structure,which guarantees the spatial information while increasing the proportion of useful channel information.The test on the ACDC dataset shows that the proposed method has higher biventricular segmentation accuracy,especially for the right ventricle segmentation.Compared with other methods,the proposed method improves the DSC coefficient by at least 2.83%,proving its effectiveness in biventricular segmentation.

Given that low-dose computed tomography significantly amplifies image noise due to the mitigation of radiation exposure,which degrades image quality and lowers the precision of clinical diagnoses,a novel model incorporating convolutional neural network and Transformer is established,in which an intra-patch feature extraction module is used to effectively preserve tiny details in the image.A double attention Transformer is constructed by incorporating a multiple-input channel attention module into the self-attention for tackling the problem of incorrect restoration of texture details during denoising using Swin Transformer.AAPM dataset is used for testing,and the results demonstrate that the proposed algorithm not only surpasses the existing algorithms in denoising performance,but also excels in preserving tiny details in the image.

To address the issues in the current lung nodule detection for tuberculosis where the existing object detection algorithms have limited precision for small nodules and often predict bounding box locations inaccurately,a lung nodule detection method based on YOLOv7 is presented for obtaining small lung nodules more effectively and realizing the continuous convergence of target detection box.Based on the framework of YOLOv7 network model,the improvements are made in the following 3 aspects.(1)The cross-channel information and target airspace information are obtained with the effective SimAM channel attention mechanism embed in the Head network,so as to highlight the target features and enable the model to identify the regions of interest more accurately.(2)SIOU boundary loss function is used to increase the angle cost on the original loss function,and redefine the distance cost and shape cost to improve the convergence rate and reduce the loss value.(3)SIOU-NMS is used to replace the non-maximum suppression algorithm for reducing the error suppression due to target occlusion.The results of experiments on a custom lung nodule dataset show that compared with the original YOLOv7,the proposed method improves accuracy and recall rate by 2.9%and 3.1%,and the mean average precision at a confidence threshold of 0.5 is increased by 3.7%.The model can effectively assist in the diagnosis of lung nodules.

Objective:To investigate the effects of curcumin on proliferation, cell cycle, and apoptosis of human thyroid cancer TPC-1 cells.Methods:Logarithmic growth phase TPC-1 cells were treated with 0.0, 7.5, 15.0 and 22.5 μmol/L curcumin for 48 h. Cell proliferation levels were determined using the methylthiazolyl tetrazolium (MTT) assay. Cell cycle and apoptosis levels were measured using flow cytometry. Western blot method was used to determine the expression levels of B cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax).Results:The inhibition rates of cell proliferation in 7.5, 15.0 and 22.5 μmol/L curcumin groups were higher than that of 0.0 μmol/L curcumin group ( P < 0.05); the proportion of G0/G1 phase was higher than that of 0.0 μmol/L curcumin group, but the proportions of G2/M and S phase were lower than those of 0.0 μmol/L curcumin group ( P < 0.05); the cell apoptosis rate was higher than that of 0.0 μmol/L curcumin group [(14.13 ± 0.57)%, (25.27 ± 0.62)%, (36.01 ± 0.84)% vs (8.48 ± 0.43)%, P < 0.05]; the protein expression of Bcl-2 was lower than that of 0.0 μmol/L curcumin group, and protein expression of Bax was higher than that of 0.0 μmol/L curcumin group ( P < 0.05). Conclusion:Curcumin can inhibit the proliferation of TPC-1 cells, block the cell cycle in G0/G1 phase, and promote cell apoptosis by downregulating Bcl-2 expression and upregulating Bax expression.

Methods:Cultured human alveolar epithelial A549 cells were assigned into LPS group and blank control group. LPS group was stimulated with LPS and adenosine triphosphate to induce pyroptosis and inflammation. A549 cells were divided into 4 groups: miR-20a mimics group, mimics-negative control (NC) group, inhibitor group and inhibitor-NC group. MiRNA-20a mimics, mimics-NC, inhibitor, and inhibitor-NC were transfected respectively into A549 cells, and after 24 h, the cells were collected to verify transfection efficiency by qPCR. MiRNA-20a mimics and the constructed TLR4-3'UTR double luciferase reporter plasmid were co-transfected into A549 cells, and luciferase activity was analyzed. MiRNA-20a mimics/inhibitors were transfected into A549 cells, and then the cells were stimulated by LPS for 8 h followed by adenosine triphosphate for 30 min. QPCR, Western Blot and ELISA were used to detect the expression of GSDMD, inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and Signaling molecules (TLR4、NF-κB) in A549 cells at mRNA level and protein level. Immunofluorescence was used to detect the expression of TLR4 in the A549 cells and NF-κB in the nucleus of A549 cells after transfecting with miRNA-20a mimics/inhibitor.Results:The mRNA and protein expression of pyroptosis marker molecule (GSDMD) and inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) in A549 cells stimulated with LPS were significantly higher than those in the blank control group, and the differences were statistically significant ( P<0.05). The expression of miRNA-20 in the mimics group was significantly higher than that in the mimic-NC group ( P<0.05), while the expression of miRNA-20a in the inhibitor group was lower than that in the inhibitor-NC group ( P<0.01). The double luciferase reporter gene experiment showed that the relative fluorescence value of the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics was significantly lower than the co-transfection group for TLR4-3'UTR-WT and miRNA-20a mimics-NC ( P<0.05). The mRNA and protein levels of pyroptosis marker molecule (GSDMD) , inflammatory factors (ASC, NLRP3, Caspase-1, IL-1β) and signaling molecules (TLR4, NF-κB) were decreased in the mimics group compared to the mimics-NC group, and increased in inhibitor group compared to inhibitor-NC group. Conclusions:miRNA-20a may inhibit LPS-induced pyroptosis and inflammation of A549 cells via TLR4/NF-κB signal pathway.Objetive:To explore the potential role of miRNA-20a in lipopolysaccharide (LPS) induced pyroptosis and inflamation of human alveolar epithelial A549 cells and its regulation mechanisim.

Objective:To evaluate the clinical value of lymph node dissection (LND) for intrahepatic cholangiocarcinoma (ICC) after surgical resection.Methods:A retrospective study was conducted on the clinical data of 156 patients who underwent surgery for ICC in Eastern Hepatobiliary Surgery Hospital of Naval Military Medical University from November 2010 to December 2017, including 94 males and 62 females, aged (60.0±9.5) years. Curative surgery was performed in 114 cases. Of 64 cases were in stage Ⅰ according to American Joint Committee on Cancer (AJCC), including 38 cases of non-lymph node dissection (NLND) and 26 cases of LND; 21 cases were in AJCC stage Ⅱ, including 11 cases of NLND and 10 cases of LND; 22 cases were in AJCC stage Ⅲb, including 14 cases of LND and 8 cases of lymph node resection (LNR); 5 cases were in AJCC stage Ⅲa, 2 cases were in AJCC stage Ⅳ. Univariate and multivariate Cox regression analysis were used for the risk factors of ICC prognosis. The log-rank test compared the survival rates of the two groups.Results:Cox multivariate analysis indicated that lymph node metastasis was independent risk factors for prognosis in patients with ICC ( HR=1.96, 95% CI: 1.09-3.55, P=0.026). A total of 114 patients were included in the curative surgery group. The 1-, 3-, and 5-year overall survival (OS) rates of the negative lymph node group ( n=91) were 65.9%, 47.3% and 35.6%, respectively, which were significantly better than those of the positive lymph node group ( n=23) who had 1-, 3-, 5-year OS rates of 56.5%, 17.7% and 0, respectively (χ 2=8.11, P=0.004 ). In stage Ⅰ and Ⅱ patients, there were no significant differences in 1-, 3-, 5-year OS rates between the NLND group and the LND group (both P>0.05 ). In stage Ⅲb patients, the LND group had 1-, 3-, 5-year OS rates of 71.4%, 29.8% and 0, respectively, significantly better than those of the LNR group who had 1-, 3-, 5-year OS rates of 37.5%, 0 and 0, respectively (χ 2=6.45, P=0.011). Conclusions:Lymph node metastasis is an independent risk factor affecting the prognosis of ICC. Lymph node dissection should be performed cautiously in ICC with AJCC stage Ⅰ and Ⅱ, while routine lymph node dissection is recommended in ICC with AJCC stage Ⅲb.

Allografts ; COVID-19 ; China/epidemiology* ; Disease Outbreaks ; Humans ; Kidney Transplantation/adverse effects* ; SARS-CoV-2

Objective    To evaluate the effect of surgical and traditional treatments for multiple rib fractures through systematic review and meta-analysis. Methods    CNKI, Wanfang, VIP, PubMed, OVID, EMbase, The Cochrane Library, Thieme and Springer Link database for information from inception to July 2019 were screened by computer. Randomized controlled trials (RCTs) of surgical and conventional methods for the treatment of multiple rib fractures were screened, assessed and extracted. RevMan 5.3 software was used for meta-analysis. Results    Twelve studies were included, including 1 039 patients. There were 512 patients in the operation group and 527 patients in the traditional treatment group. The results of meta-analysis showed that there was a significant difference between the two groups in the incidence of pneumonia (RR=0.41, 99%CI 0.29 to 0.58, P<0.000 01), incidence of atelectasis (RR=0.24, 99%CI 0.06 to 0.94, P=0.007), duration of mechanical ventilation (SMD=–2.64, 99%CI –4.38 to –0.91, P<0.000 1), duration of intensive care unit stay (SMD=–1.33, 99%CI –2.26 to –0.40, P=0.000 2), duration of hospital stay (SMD=–2.25, 99%CI –3.30 to –1.19, P<0.000 01) and incidence of chest wall deformity (RR=0.08, 99%CI 0.04 to 0.17, P<0.000 01). There was no significant difference between the two groups in the hospital mortality (RR=0.75, 99%CI 0.23 to 2.46, P=0.53), incidence of tracheostomy (RR= 0.69, 99%CI 0.39 to 1.21, P=0.09), ventilator support rate (RR=0.65, 99%CI 0.41 to 1.05, P=0.02) and chest drainage time (SMD=–2.58, 99%CI –6.41 to 1.25, P=0.08). Conclusion    Surgical treatment of multiple rib fractures can reduce pulmonary complications, shorten hospital stay, and reduce the incidence of chest wall deformity, which is conducive to rapid recovery and improves quality of life.

Objective To observe the effects of total enteral nutrition ( TEN) and early combined parenteral nutrition ( PEN+TEN) in patients with esophageal cancer after operation .Methods The prospective,random, controlled clinical trial was adopted.One hundred patients receiving esophageal cancer operation were randomly assigned to the TEN group (50 cases) and the PEN+TEN group(50 cases).The differences in nutritional status, inflammatory response, immune status and postop-erative complications were compared in the two groups before and after operation.Results The levels of total serum protein, albumin or retinol binding protein were higher in the PEN group than the TEN group at the 10th day after operation, respective-ly[(60.1 ±6.2)g/L vs(55.3 ±9.3)g/L,(36.4 ±4.2)g/L vs(34.6 ±1.6)g/L,(43.3 ±5.9)g/L vs(34.9 ±3.3)g/L, P<0.05] .The levels of ESR or CRP were higher in PEN +TEN group than the TEN group at the 10th day after operation, re-spectively [(54.9 ±25.8)mm/h vs(31.8 ±14.2)mm/h,(30.9 ±13.2)g/L vs(15.8 ±6.1)g/L, P<0.01] .The levels of CD3+, CD4 +, or CD8 +were higher at the 10 th day after operation than at the day before surgery in TEN group [(59.6 ±9.8)％vs(68.3 ±4.4)％,(41.7 ±7.8)％vs(46.5 ±5.5)％,(23.2 ±5.5)％vs(20.0 ±2.7)％, P<0.05], but not in PEN+TEN group.The levels of IgA or IgG were significant higher in the TEN group than the PEN +TEN group at the 10th day after operation[(1.9 ±0.5)g/L vs(1.6 ±0.3)g/L,(11.9 ±3.3)g/L vs(9.4 ±2.2)g/L, P<0.01].Con-clusion The inflammatory reaction and immune function in TEN group are better than those in PEN +TEN group.Although the nutritional status is worse in the TEN group than that in the PEN group , but the rate of postoperative complications has not increased.