In recent years, the corona virus disease 2019 (COVID-19) pandemic has had a huge impact on the global medical, political and economic fields. Since the beginning of the COVID-19 epidemic, our understanding of the impact of COVID-19 has grown exponentially. Recently, the COVID-19 epidemic has changed rapidly in China, and there has been controversy over how to carry out surgical operations for patients with lung neoplastic lesions. Some studies have shown that lung cancer patients undergoing surgery are more likely to experience respiratory failure and perioperative death after contracting COVID-19 than the general population, however, delays in cancer treatment are also associated with increased mortality among these patients. In particular, the novel coronavirus Omikron variant has a higher transmissibility and may escape the immunity obtained through the previous novel coronavirus infection and vaccination. In order to minimize the risk of novel coronavirus infection in surgical patients, it is necessary to develop new treatment guidelines, expert consensus and preventive measures. However, the current rapid change of the epidemic situation has led to insufficient time and evidence to develop guidelines and consensus. Therefore, thoracic surgeons need to evaluate specific patient populations at higher risk of severe complications before surgery and weigh the benefit of surgical treatment against the risk of novel coronavirus infection. We try to give some recommendations on lung surgery during the current domestic epidemic situation based on the guidelines and consensus of oncology and thoracic surgery organizations in different regions on lung surgery.
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Humans ; Lung Neoplasms/complications* ; COVID-19 ; SARS-CoV-2 ; Multiple Pulmonary Nodules ; Pandemics/prevention & control* ; Lung

The genomic instability may lead to an initiation of cancer in many organisms. Homologous recombination repair (HRR) is vital in maintaining cellular genomic stability. RAD51 associated protein 1 (RAD51AP1), which plays a crucial role in HRR and primarily participates in forming D-loop, was reported as an essential protein for maintaining cellular genomic stability. However, recent studies showed that RAD51AP1 was significantly overexpressed in various cancer types and correlated with poor prognosis. These results suggested that RAD51AP1 may play a significant pro-cancer effect in multiple cancers. The underlying mechanism is still unclear. Cancer stemness-maintaining effects of RAD51AP1 might be considered as the most reliable mechanism. Meanwhile, RAD51AP1 also promoted resistance to radiation therapy and chemotherapy in many cancers. Thus, researches focused on RAD51AP1, and its regulatory molecules may provide new targets for overcoming cancer progression and treatment resistance. Here, we reviewed the latest research on RAD51AP1 in cancers and summarized its differential expression and prognostic implications. In this review, we also outlined the potential mechanisms of its pro-cancer and drug resistance-promoting effects to provide several potential directions for further research.
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Humans ; DNA-Binding Proteins/metabolism* ; RNA-Binding Proteins/metabolism* ; Lung Neoplasms ; DNA Repair ; Genomic Instability ; Rad51 Recombinase/metabolism*

A 61-year-old male patient was simultaneously diagnosed with lung adenocarcinoma and inflammatory myofibroblastic tumor (IMT). The lung adenocarcinoma and IMT harbored two distinct types of ALK translocation, LOC101927285-ALK, and TPM3-ALK, respectively. The ALK Ventana showed strong positivity on both lesions. The patient was therefore given an endobronchial cryotherapy and ALK inhibitor crizotinib. The tumors showed durable response however the left lung adenocarcinoma relapsed at 17th month post-crizotinib treatment. Tissue re-biopsy on the resistant tumor revealed an ALK exon 23 C1156Y missense mutation in addition to LOC101927285-ALK mutation. Further RNA-based sequence uncovered that the noncoding region rearrangement is the fusion mutation of EML4-ALK. The patient was therefore received alectinib, and the tumor exhibited partly response. Overall, it is very rare that two types of pulmonary tumors exist in one patient driven by two distinct ALK fusions, which emphasizes the necessity of gene sequencing in clinical decision-making and individualized therapy.

A 61-year-old male patient was simultaneously diagnosed with lung adenocarcinoma and inflammatory myofibroblastic tumor (IMT). The lung adenocarcinoma and IMT harbored two distinct types of ALK translocation, LOC101927285-ALK, and TPM3-ALK, respectively. The ALK Ventana showed strong positivity on both lesions. The patient was therefore given an endobronchial cryotherapy and ALK inhibitor crizotinib. The tumors showed durable response however the left lung adenocarcinoma relapsed at 17th month post-crizotinib treatment. Tissue re-biopsy on the resistant tumor revealed an ALK exon 23 C1156Y missense mutation in addition to LOC101927285-ALK mutation. Further RNA-based sequence uncovered that the noncoding region rearrangement is the fusion mutation of EML4-ALK. The patient was therefore received alectinib, and the tumor exhibited partly response. Overall, it is very rare that two types of pulmonary tumors exist in one patient driven by two distinct ALK fusions, which emphasizes the necessity of gene sequencing in clinical decision-making and individualized therapy.

Metastatic pleomorphic liposarcoma in the mediastinum is rare, and the current treatments are most of the times ineffective. We hereby report a case with relapsed pleomorphic liposarcoma adjacent to the psoas major mus-cle and with mediastinal metastasis, to discuss the clinical features and treatment strategies of pleomorphic liposarcoma. The patient's clinical history, imaging findings, pathological diagnosis, and multidisciplinary treatments were retrospectively analyzed. A 41-year old female patient was diagnosed with pleomorphic liposarcoma adjacent to the psoas major muscle and mediastinal metastasis. After multidisciplinary treatments, including surgery, chemotherapy, and targeted therapy, the patient has survived 65 months until now. Surgical resection is considered as the first choice of the treatment for pleomorphic lipo-sarcoma. Multidisciplinary treatments, including chemotherapy and other medical treatments, are effective to slow the disease progression and to reduce the disease recurrence.

Objective To investigate the protective effects of isopimaric acid ( ISO), the BKCa channel activator, on cognitive function and synaptic plasticity in APP/PS1 mice. Methods Alzet osmotic pump was loaded with ISO or DMSO only and assembled with ALZET Brain Infusion Kit III. The cannula was implanted into the lateral ventricle of 4-month-old male APP/PS1 mice or matched wild type ( WT) mice. Two weeks later, open field test and Morris water maze were conducted. Paired-pulse facilitation ( PPF) and TBS-induced long-term potentiation ( LTP ) were recorded in CA1 region of hippocampus. Results The open field test showed that there was no significant difference among the four groups in spontaneous activities and vertical plane movement distance within 30 minutes. Floor plane movement distance was significantly greater in APP/PS1+DMSO group than that in WT+DMSO group(P<0.05) . Compared with the WT+DMSO group, APP/PS1+DMSO group had significantly longer escape latency from the third to fifth day and lower percentage of time spent in the target quadrant ((43.27±3.24)% vs (34.19±2.56)%) and the number of crossing through the platform ((4.25±0.66)times vs (1.93±0.33)times)(P<0.05). Compared with the APP/PS1+DMSO group, the APP/PS1+ISO group had significantly shorter escape latency from the fourth to fifth day and higher percentage of time spent in the target quadrant ((46.16±3.51)%) and the number of crossing through the platform ((3.41±0.34) times) (P<0.05). PPF in APP/PS1+DMSO group significantly reduced compared with that in WT+DMSO group at 30-50ms interstimulus interval(P<0.05). PPF in APP/PS1+ISO group((224.50±13.79)%) was significantly augment compared with APP/PS1+DMSO ((174.99 ±6.68)%) group at 40 ms interstimulus interval (P<0.05). The LTP at 60 min post-TBS was significantly smaller in the APP/PS1+DMSO group ((135.19±1.32)%) than that in the WT+DMSO group ((172.17± 4.15)%)(P<0.001). The LTP of the APP/PS1+ISO group((160.48±1.19)%) became significantly in-creased compared with that in the APP/PS1+DMSO group(P<0.001).Conclusion BKCa channel activator ISO improve the learning and memory function of APP/PS1 mice by promoting PPF and increasing LTP to recover synaptic plasticity in the hippocampus.

Objective: To evaluate the clinical efficacy of posterior short segment pedicle screw fixation combined with transpedicular intracorporeal grafing in the treatment of thoracolumbar fractures .Methods :The clinical data of 30 patients with thoracolumbar fractures ,who were admitted and treated with posterior short segment pedicle screw fixation combined with transpedicular intracorporeal grafting during June 2011 and June 2013 ,were retrospectively analyzed .The operation time ,intra‐operational bleeding amount , preoperative and postoperative visual analogue scale (VAS ) score ,the ratio of anterior and posterior vertebral height ,Cobb angle ,neurological function(Frankel grade) and complications were recorded .Results:All the cases had been followed up for 14 .6 months averagely(range from 6 to 23 months) .There was significant difference between the VAS score at the last follow‐up and the preoperative one (P<0 .05) .The ratio of anterior and posterior vertebral height as well as the Cobb angle improved significantly at the 3rd day after operation and the last follow‐up as compared with preoperative ones(P<0 .05) .The ratio of anterior and posterior vertebral height as well as Cobb angle at the 3rd day after operation was not significantly different from that at the last follow‐up(P>0 .05) .The postoperative Frankel grade in patients with neurological function damage improved significantly .There was no breakage or loosening happened with the internal fixation .Conclusions :The posterior short segment pedicle screw fixation combined with transpedicular intracorporeal grafting can reconstruct vertebral body height ,rebuild anatomic form of vertebra ,obtain better kyphosis correction ,maintain the correction effect and avoid the long term lumbago and back pain .This surgical method is safe and effective .

OBJECTIVETo establish a novel nude mice model which can be visualized in real time and detected in a continuous and dynamic way for the development and metastasis of adenoid cystic carcinoma.

METHODSHuman adenoid cystic carcinoma cells, ACCM cell line, were infected with retroviral vector of pLEGFP-N1 and then screened for a single colony of ACCM-GFP cells. Cell proliferation and morphological analysis were conducted for ACCM and ACCM-GFP cells. Nude mice lingual carcinoma model was set up with ACCM-GFP cells injection and real time observation with fluorescence imaging on ACCM-GFP tumors was performed subsequently. Histological assay was analyzed for ACCM and ACCM-GFP tumors as well.

RESULTSACCM-GFP cells were able to express GFP stably in the long term. ACCM and ACCM-GFP cells showed no significant difference in cell proliferation and morphology, and no significant difference of histological characteristics in vivo could be found between ACCM and ACCM-GFP tumors. Tumor development could be monitored in real time with fluorescence imaging system in vivo.

CONCLUSIONGFP-expressing ACCM tumor model can be applied to detect and observe its development in the long term in a noninvasive, real time and dynamic way. It is also a kind of ideal in vivo mouse model for adenoid cystic carcinoma research.

Animals ; Carcinoma, Adenoid Cystic ; Cell Line, Tumor ; Cell Proliferation ; Disease Models, Animal ; Green Fluorescent Proteins ; Humans ; Mice ; Mice, Inbred BALB C ; Mice, Nude

Background and objective It has been proven that heparanase and Ki-67 had relationship with occur-rence and metastasis in lung cancer. The aim of this work was to investigate the expressions of heparanase and Ki-67 and to ex-plore their clinical significance and mutual relations in non-small cell lung cancer (NSCLC). Methods Immunohistochemical method was used to detect the heparanase and Ki-67expression in the routinely paraffin-embedded sections of surgical specimen of 70 cases with NSCLC and 20 ones with normal lung tissues. Results Heparanase and Ki-67 were highly expressed in lung cancer tissues (72.996 and 85.796) while negative in epithelia of normal lung tissues. The expression of heparanase was signifi-cantly correlated with TNM stage (P=0.044) and lymphatic metastasis (P=0.001). The expression of Ki-67 was significantly cor-related with tumor size (P=0.03) and histology type (P=0.001) and differentiation (P=0.01) and lymphatic metastasis (P=0.01) and TNM stage (P=0.043). The expression ofhaparanase and Ki-67 was no significant difference (P=0.323). Conclusion Hepa-ranase and Ki-67 were involved in the occurrence and development of lung cancer and they may predict patients prognosis, while the expression of heparanase and Ki-67 had no association with NSCLC, which may contribute to the different mechanisms involved in tumor occurrence and development.

: Rehabilitation medicine is a medical branch which focused on functional recovery. Function Evaluation is very important in assessing the function of patients, the effect of treatment and the efficiency of rehabilitation. Comprehensive Function Evaluation includes evaluation of physical, psychological, speech and society. Vocal, mental and social evaluation have deep cultural and national background. Therefore every country must have its own Function Evaluation Method. Now we present our design for Comprehensive Evaluation. Based on the cooperation of Department of Rehabilitation, Department of Neurology, Department of Spinal Cord Injury, Department of Speech Therapy and Department of Psychology. The advantages of this method are as follows: 1. The style of ADL, speech and thinking are suitable for the condition of our country. 2. The evaluation result adopts hundred work system, it is easy for medical staff, patients and their family to understand and communicate the result. 3. We make it more accurate, comprehensive and reliable by some simple tests on speech pathology and psychology. 4. We overcome some disadvantages of evaluation indexes because it is not correct and is difficult to be understood before. Now every evaluation index has quantity standard. 5. It is simple and practical. Each subtest takes 20 minutes or more. 6. It has been tested by normal people. The norm and severity grade had been developed. 7. The reliability is tested and is proved to be dependable.