Objective:To observe the clinical effect of neurodynamic techniques combined with McKenzie diagnosis and therapy on patients with cervical spine radiculopathy,and to explore a better clinical treatment method for pa-tients with cervical spine radiculopathy. Method:Thirty-three patients with cervical spine radiculopathy who met the inclusion and matched the base-line characteristics were randomly divided into the two groups:the McKenzie treatment group(n=16)and the combined treatment group(n=17)according to the random number table.The patients in both groups received conventional physical treatment and Mechanical diagnosis and therapy,while the combined treatment group re-ceived neurodynamic techniques additionally.Before treatment and 2 weeks after treatment,the cervical range of motion(ROM)was measured,and the visual analogue scale(VAS)was used to evaluate the patients'pain level and the neck disability index(NDI)were used to assess the functional status and treatment outcome. Result:Before treatment,there were no significant differences in cervical ROM,VAS and NDI between two groups(P＞0.05).After two weeks of treatment,the outcome of the combination group showed significant im-provements cervical ROM for flexion(42.65±3.12)°,extension(40.88±4.05)°,left lateral flexion(41.18±4.52)°,right lateral flexion(42.06±4.70)°,left rotation(73.53±5.80)°,and right rotation(74.71±7.39)°,the VAS score was 0.76±0.75,NDI score was 3.82±3.47,compared with both the baseline and the control group(P＜0.05). Conclusion:Neurodynamic techniques combined with McKenzie diagnosis and therapy provide more effective relief of pain and ROM limitations in patients with cervical spine radiculopathy,accelerating the recovery of cervical function.The combination therapy is a useful clinical treatment option.

Objective:To explore any changes in the electromyographic (EMG) signals from the deep lumbar multifidus (DM) of patients with chronic low back pain (cLBP).Methods:Twenty-five cLBP patients formed the cLBP group, while twenty-eight healthy counterparts similar in sex, age and education background were chosen as the control group. EMG signals were recorded during maximum isometric voluntary contraction of the DM. Two-way repeated measures analysis of variance was applied to compare the two groups′ signals′ Lempel-Ziv (LZ) complexity values at rest and during the maximum strength, strength endurance and relaxation stages of contraction. Pearson correlation coefficients were computed relating the LZ complexity to pain duration and intensity, as well as to Oswestry disability index (ODI) values in the cLBP group.Results:The cLBP patients reported a mean symptom duration of 5.96±4.69 years, with an average VAS score of 4.00±1.04 and ODI of 17.12±10.49. They reported greater pain intensity during needle insertions, needle removal, muscle contraction and relaxation than the healthy controls. There were significant differences in LZ complexity among the four stages of contraction with all of the subjects. The LZ complexity was significantly lower in the maximum strength and strength endurance states, but higher in the relaxation after contraction states in the cLBP group. Pain duration was negatively correlated with the nonlinear index of DM during contraction.Conclusion:Continuous pain stimulation will affect the coordinated control of the deep multifidus muscle, leading to decreased control of core muscles via the central nervous system. That provides insight into the mechanisms underlying activation and coordinated control during chronic pain.

Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.

Objective:To evaluate the long-term efficacy of laparoscopic-assisted natural orifice specimen extraction surgery (NOSES) colectomy using Cai tube for treating left-sided colorectal cancer.Methods:This was a randomized controlled trial. Inclusion criteria were as follows: preoperative pathological diagnosis of left-sided colorectal adenocarcinoma (rectal, sigmoid colon, descending colon, or left transverse colon cancer with the caudad margin ≥8 cm from the anal margin); preoperative abdominal and pelvic computed tomography (or magnetic resonance imaging) showing maximum tumor diameter <4.5 cm; and BMI <30 kg/m 2. Patients with synchronous multiple primary cancers or recurrent cancers, a history of neoadjuvant chemoradiotherapy, preoperative evidence of significant local infiltration, distant metastasis, or complications such as intestinal obstruction and intestinal perforation, or who were not otherwise considered suitable for laparoscopic surgery were excluded. A random number table was used to randomize sequential patients to NOSES surgery using Cai tube (non-assisted incision anal sleeve: patent number ZL201410168748.2) (NOSES group) or traditional laparoscopic-assisted surgery (CLS group). Relevant clinical data of the two groups of patients were analyzed, the main outcomes being disease-free survival, overall survival, overall recurrence rate, and local recurrence rate 5 years after surgery. Results:Patients in both study groups completed the surgery successfully with no requirement for additional surgery. After mean 70 (7–83) months postoperative follow-up, the 5-year overall postoperative survival in the NOSES and CLS groups was 90.0% and 83.3%, respectively ( P=0.455); disease free survival was 90.0% and 83.3%, respectively ( P=0.455); overall recurrence rate 6.6% and 10.0%, respectively ( P=0.625); and local recurrence rate both were 3.3% ( P=0.990), respectively. None of these differences was statistically significant. Conclusions:NOSES and CLS have similar long-term efficacy, and NOSES deserves to be used in clinical practice.

Objective:To investigate the clinical effects of acupuncture therapy on post-hemiplegia neck and shoulder pain.Methods:Eighty patients with post-stroke hemiplegia with neck and shoulder pain who received treatment in Department of Acupuncture, Massage and Physiotherapy, Zhejiang Provincial Armed Police Corps Hospital between December 2020 and June 2021 were included in this study. They were randomly assigned to undergo either conventional rehabilitation treatment and analgesic tablets (control group, n = 40) or conventional rehabilitation treatment, analgesic tablets and acupuncture therapy in combination (observation group, n = 40). Traditional Chinese medicine efficacy, western medicine efficacy, degree of neurological deficits, ability of daily living, and the incidence of adverse reactions were compared between the two groups. Results:After treatment, traditional Chinese medicine efficacy and western Chinese medicine efficacy in the observation group were significantly higher than those in the control group (87.50% vs. 52.50%, 82.50% vs. 55.00%), and the incidence of adverse reactions in the observation group was significantly lower than that in the control group (17.50% vs. 42.50%, χ2 = 21.48, 16.33, 9.12, all P < 0.05). In the control group, National Institutes of Health Stroke Scale (NIHSS) score measured after treatment was significantly lower than that measured before treatment [(7.58 ± 1.87) points vs. (14.87 ± 1.36) points, t = -9.58, P < 0.001], and Barthel Index (BI) measured after treatment was significantly higher than that measured before treatment [(53.78 ± 1.34) points vs. (37.92 ± 1.74) points, t = 6.35, P < 0.001]. In the observation group, NIHSS score measured after treatment was significantly lower than that measured before treatment [(5.44 ± 2.11) points vs. (14.51 ± 0.34) points, t = -12.69, P < 0.001], and BI measured after treatment was significantly higher than that measured before treatment [(62.02 ± 0.68) points vs. (37.73 ± 1.58) points, t = 7.45, P < 0.05]. BI post-measurement in the observation group was significantly higher than that in the control group [(62.02 ± 0.68) points vs. (53.78 ± 1.34) points, t = 4.35, P < 0.05]; NIHSS score post-measurement in the observation group was significantly lower than that in the control group [(5.44 ± 2.11) points vs. (7.58 ± 1.87) points, t = -8.48, P < 0.05]. Conclusion:Acupuncture treatment for post-hemiplegia neck and shoulder pain can markedly reduce pain in patients, improve prognosis and increase clinical efficacy.

Lung cancer is the most common malignant tumor in the world. In order to improve the survival rate of patients with advanced lung cancer, more effective treatment methods are needed,in which immunotherapy has a broad therapeutic prospect. In recent years, immune-checkpoint inhibitors have received extensive attention in the treatment of lung cancer. Significant progress has been made in the development of a variety of first-line and second-line treatments, and significant advances have been made in the treatment of advanced lung cancer. With the successful application of immune-checkpoint inhibitors, neoadjuvant therapy has attracted extensive attention. In addition, the successful application of combined therapies such as immune combined immunization, immune combined tyrosine kinase inhibitor (TKI) and immune combined chemotherapy improved the survival rate of patients to some extent. However, pseudo progression and drug resistance has become a non-negligible problem in the immunotherapy of non-small cell lung cancer, which is worthy of further study. Although immune-checkpoint inhibitors have once again brought attention to tumor immunotherapy, their side effects are also worthy of attention. The recent advances in the application of immune-checkpoint inhibitors in lung cancer were summarized in order to provide a theoretical basis for its clinical application.

Objective: The expression of WNT5A is associated with aggressive tumor biology and poor clinical outcomes of various types of cancer. However, its function in the cell migration of small cell lung cancer (SCLC) should be elucidated. Methods:The expres-sion of WNT5A in SCLC and normal lung tissues was detected by immunohistochemisty. The correlation between the expression and clinical characteristics of WNT5A was analyzed. The function of WNT5A in regulating cell migration was studied in DMS153 cell line in vitro. Small interfering RNA (SiRNA) was used to knock down WNT5A. Wound healing and Transwell tests were used to determine the migration rate of DMS153. The phosphorylated JNK expression was detected by Western blot analysis. Results:The WNT5A expression was higher in SCLC tissues than that of normal lung tissues. WNT5A was correlated with clinical stages, lymph nodes, and distance me-tastasis in SCLC. The high expression of WNT5A was accompanied by abnormal levels of NSE and Pro-GRP. The WNT5A phosphoryla-tion of JNK promoted cell migration in vitro. Conclusion:The expression of WNT5A in SCLC is high and correlated with tumor metasta-sis. The influence of WNT5A/JNK on the cell migration property of DMS153 supports the concept that WNT5A can initiate the cell mi-gration of SCLC, which suggested that WNT5A may be a marker and can be potentially used as an effective therapeutic target for the SCLC metastasis.

Objective:The clinical factors of single-port video-assisted thoracoscopic surgery (SP-VATS) were compared with those of multi-port video-assisted thoracoscopic surgery (MP-VATS). The differences between the two surgical methods and their respective postoperative recoveries were also discussed. Methods:A total of 522 patients who underwent surgical treatment for lung cancer in Tianjin Medical University Cancer Institate and Hospital from January, 2014 to December, 2015 were retrospectively reviewed. Of these cases, 83 underwent SP-VATS and 439 underwent MP-VATS. The two surgical methods were then compared in terms of opera-tive time, operative bleeding, number of lymph node and lymph node cleaning station, pain degree, 24 h postoperative chest drain-age, and in-hospital time after operation. Results:The differences between the patients who underwent SP-VATs and those who under-went MP-VATS in term of gender, age, smoking, tumor diameter, TNM stage, pathological type, and tumor location were not statistical-ly significant. The operative time in SP-VATS group was longer than that in the MP-VATS group (P<0.01), whereas in-hospital time after operation in the former group was shorter than that in the latter (P=0.011). Furthermore, pain degree in the SP-VATS group is lower than that in the MP-VATS group (P=0.041). The differences between the two groups in terms of operative bleeding, number of lymph node and lymph node cleaning station, and 24 h postoperative chest drainage were not statistically significant. Conclusion:SP-VATS can achieve a surgical effect similar to that of MP-VATS but has a prolonged operation time. SP-VATS is beneficial to postoperative re-covery and reduces the degree of pain. Thus, it has great potential for development.

[Objective] To explore the characteristics of the plantar pressure data of the patients with adolescent idiopathic scoliosis (AIS).[Methods] 56 AIS patients who were diagnosed from October 2015 to March 2017 in the East branch of the First Affiliated Hospital of Sun Yat-sen University divided into 3 groups,18 cases in spinal lateral bending to right,18 cases in spinal lateral bending to left,20 cases in type S who were thoracolumbar scoliosis.Another 19 healthy persons were as the control group.The left and right foot pressure,half foot pressure and other biomechanical data were compared.The changes of the plantar pressure and the Cobb angle were analyzed with the patients who wore orthopedic insoles.[Results] Compared with the control group,the mean pressure of the left foot and the pressure of the left anterior half of the right bending group were less than those of the control group,and the right half foot pressure were greater than those of the control group (P ＜ 0.017).To the left bending group,the mean pressure of right anterior half foot were less than those of the control group,and the right rear half foot pressure was greater than that of the control group (P ＜ 0.017).The pressure of the left anterior half foot of the S type scoliosis group was less than that of the control group.To the right bending group,the left foot average pressure (44.7％±6.0％) was significantly less than the average pressure of right foot (55.4％ ± 6.0％).There was no difference in bilateral plantar pressure of the left bending group,S type group and control group.There was difference with the plantar pressure distribution in patients with only one curve after they wore orthotic insoles,but there was no difference in patients with type S.There was no significant difference in the Cobb angle after the patients wearing the orthotic insoles (P =0.102).[Conclusions] The right and left foot pressure symmetry of the right bending patients is poor,but the left and right plantar pressure in the patients with type S is symmetrical.The orthotic insole can be used to adjust the plantar pressure distribution in patients with a single curved scoliosis (left or right),but their effect on the patient's spinal lateral curvature should be further observed.

OBJECTIVEThis study aimed to explore the expression of tumor-derived colony-stimulating factor 1 (CSF1), its prognostic significance and underlying related mechanisms in resected lung adenocarcinoma (ADC).

METHODSImmunohistochemistry and tissue microarray were used to detect the expression of CSF1, epidermal growth factor receptor (EGFR), and CD68 in 266 patients with lung adenocarcinoma treated in our department between 2004 and 2008.

RESULTSIn the 266 ADC cases, the positive rates of expression of CSF1, EGFR and CD68 proteins were 56.4%, 42.1% and 81.2%, respectively. The expression level of CSF1 was positively correlated with TNM stage, number of involved nodal stations, tumor recurrence and EGFR expression (P<0.05). Univariate analysis indicated that TNM stage, number of involved lymph nodes, number of involved nodal stations, CSF1 expression, the combination of CSF1/EGFR and co-expression of CSF1/CD68/EGFR were statistically significant for prognosis (P<0.05). The results of multivariate analysis showed that TNM stage, co-expression of CSF1/EGFR and CSF1/CD68/EGFR were significant and independent risk factors for survival (P<0.05). Correlational analysis showed that expression of CSF1 and EGFR in the tumors was positively correlated to the degree of infiltration of interstitial tumor-associated macrophages (TAMs) (respectively; P<0.05).

CONCLUSIONSThe expression of CSF1 indicates a poor prognosis in postoperative lung adenocarcinoma. Co-expression of CSF1 and EGFR may be a valuable independent prognostic predictor, and its mechanism is probably involved in the interaction of cancer cells and TAMs in the progression of lung adenocarcinoma.

Adenocarcinoma ; diagnosis ; metabolism ; Disease Progression ; Humans ; Immunohistochemistry ; Lung Neoplasms ; diagnosis ; metabolism ; Macrophage Colony-Stimulating Factor ; metabolism ; Macrophages ; Prognosis