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Background Although systemic inflammation is an important feature of the cancer cachexia, studies on the association between systemic inflammation and prognostic of cancer cachexia are limited. The objective of this study is to evaluate whether the neutrophil‐to‐lymphocyte ratio (NLR) is associated with outcome and quality of life for patients with cancer cachexia and investigated any interaction between NLR and the clinical parameters. Methods This is a multicentre cohort study of 2612 cancer patients suffering from cachexia diagnosed between June 2012 and December 2019. The main parameters measured were overall survival (OS) time and all‐cause mortality. The association between NLR and all‐cause mortality was evaluated using hazard ratios (HRs) and the restricted cubic spline model with a two‐sided P‐value. Optimal stratification was used to solve threshold points. We also evaluated the cross‐classification of NLR for each variable of survival. Results Of the 2612 participants diagnosed with cancer cachexia, 1533 (58.7%) were male, and the mean (SD) age was 58.7 (11.7) years. Over a median follow‐up of 4.5 years, we observed 1189 deaths. The overall mortality rate for patients with cancer cachexia during the first 12 months was 30.2% (95%CI: 28.4%–32.0%), resulting in a rate of 226.07 events per 1000 patient‐years. An increase in NLR had an inverted L‐shaped dose–response association with all‐cause mortality. The optimal cut‐off point for NLR as a predictor of mortality in cancer patients with cachexia was 3.5. An NLR of 3.5 or greater could independently predict OS (HR, 1.51, 95%CI: 1.33–1.71). These associations were consistent across subtypes of cancer. Several potential effect modifiers were identified including gender, BMI, tumour type, KPS score and albumin in content. Increasing NLRs were independently associated with a worsening in the majority of EORTC QLQ‐C30 domains. Elevated baseline NLR was associated with low response and poor survival in patients treated with immunotherapy. Conclusions The baseline NLR status was found to be a significant negative prognostic biomarker for patients with cachexia; this effect was independent of other known prognostic factors.

Objective: Breastfeeding is known to have a positive impact on maternal and neonatal health. Some have suggested that gestational diabetes mellitus (GDM) is associated with lower breastfeeding rates, but it is not known whether rates are further impacted by glucose control in pregnancy. Thus, we examined whether patients with GDM requiring medication (A2 GDM) were more likely to not initiate or discontinue breastfeeding compared with patients with GDM well controlled by diet (A1 GDM). Research Design and Methods: This is a secondary analysis of a prospective cohort study of 600 patients with GDM. Eligible patients were enrolled during their delivery hospitalization and followed prospectively postpartum. The primary outcome was exclusive breastfeeding at hospital discharge and secondary outcomes included breastfeeding rates at 3 months postpartum. Patients classified as A2 GDM were compared with those classified as A1 GDM. Results: Of the 600 patients enrolled, 301 had A2 GDM and 299 had A1 GDM. Patients who needed medication were observed to be older and more likely to be parous and obese. There were no significant differences in labor outcomes or neonatal complications. After adjusting for baseline differences between the two groups, adjusted odds ratios (aORs) for exclusive breastfeeding rates were similar in mothers with A2 GDM compared with those with A1 GDM at hospital discharge (aOR 0.83 [0.54-1.28]) and 3 months postpartum (aOR 0.58 [0.34-1.01]). Additionally, any breastfeeding rates were similar in mothers with A2 GDM compared with those with A1 GDM, both at hospital discharge (aOR 0.72 [0.44-1.16]) and 3 months postpartum (aOR 0.63 [0.34-1.17]). Conclusions: After adjusting for baseline differences, there was no difference in any or exclusive breastfeeding rates at hospital discharge or 3 months postpartum among patients with A2 GDM compared with those with A1 GDM.

Background:. Liver fibrosis (LF) continues to develop and eventually progresses to cirrhosis. However, LF and early-stage cirrhosis (ESC) can be reversed in some cases, while advanced cirrhosis is almost impossible to cure. Advances in quantitative imaging techniques have made it possible to replace the gold standard biopsy method with non-invasive imaging, such as radiomics. Therefore, the purpose of this study is to develop a radiomics model to identify LF and ESC. Methods:. Patients with LF (n = 108) and ESC (n = 116) were enrolled in this study. As a control, patients with healthy livers were involved in the study (n = 145). Diffusion-weighted imaging (DWI) data sets with three b-values (0, 400, and 800 s/mm2) of enrolled cases were collected in this study. Then, radiomics features were extracted from manually delineated volumes of interest. Two modeling strategies were performed after univariate analysis and feature selection. Finally, an optimal model was determined by the receiver operating characteristic area under the curve (AUC). Results:. The optimal models were built in plan 1. For model 1 in plan 1, the AUCs of the training and validation cohorts were 0.973 (95% confidence interval [CI] 0.946–1.000) and 0.948 (95% CI 0.903–0.993), respectively. For model 2 in plan 1, the AUCs of the training and validation cohorts were 0.944, 95% CI 0.905 to 0.983, and 0.968, 95% CI 0.940 to 0.996, respectively. Conclusions:. Radiomics analysis of DWI images allows for accurate identification of LF and ESC, and the non-invasive biomarkers extracted from the functional DWI images can serve as a better alternative to biopsy.

To observe the efficacy of electroacupuncture (EA) plus Yi Jin Jing (Sinew-transforming Qigong Exercises) for knee osteoarthritis (KOA). A total of 60 patients with KOA were divided into an observation group and a control group according to the random number table method, with 30 cases in each group. Patients in the observation group received the treatment of EA plus Yi Jin Jing (Sinew-transforming Qigong Exercises), while patients in the control group only received EA treatment. Both groups were treated for 5 weeks. The changes of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores in the two groups were observed after treatment. After treatment, the total effective rate in the observation group (92.3%) was significantly higher than that in the control group (70.0%), (P

Glioma is a kind of common malignant tumor in neurosurgery and has a high mortality and morbidity rate, which poses a serious threat to the health of people all over the world. Surgery is the preferred treatment for patients with glioma, radiotherapy or chemotherapy can be used after surgery. Although there are clear therapeutic protocols, the efficacy and safety of these protocols are clinically proven, a large number of patients are still dissatisfied with the treatment and the health of the patient remains unsatisfactory. Therefore, it is crucial to look for other treatments or complementary treatments. In the modern medical treatment, hyperbaric oxygen (HBO) therapy is widely used in various kinds of pathological state of adjuvant therapy, and existing studies confirm the efficacy of HBO therapy in combination with surgery, radiotherapy, chemotherapy, and photodynamic therapy. Studies have shown that HBO can inhibit the growth of tumor tissue as an adjunctive therapy. This provides novel insights into the clinical treatment of glioma patients. Although HBO is not licensed for use in cancer treatment, as a kind of adjuvant therapy, the treatment effect of HBO can be accepted by the patients and its cost lower, which could be regarded as an ideal safe treatment.

This study included data from 81 consecutively enrolled patients with hematological diseases who had been treated with unrelated umbilical cord blood transplantation (UCBT) between September 2014 and April 2019. All patients received intense conditioning regimens with combined fludarabine and high-dose cyclophosphamide (FC) before undergoing UCBT. Sixty-seven patients received a single UCBT, and 14 patients received a double UCBT. Fifty patients were pretreated with the fludarabine, busulfan, and cyclophosphamide (FBC) protocol, while 31 patients were treated with FC before transplantation. Graft-versus-host disease (GVHD) was prevented with cyclosporine A and mycophenolate mofetil administration. According to low-resolution, human leukocyte antigen (HLA) donor-recipient matching at six sites, 53 patients had 5-6 matches, while 28 patients had 4 matches. Seventy-eight patients (96.3%) achieved complete engraftment in this study. Thirty-six patients developed acute GVHD (aGVHD). The cumulative incidence of grade I-II aGVHD at day 100 posthematopoietic stem cell transplantation was 29.6%, and the cumulative incidence of grade III-IV aGVHD was 14.8%. At the end of the follow-up, 12 patients died due to treatment-related complications, and 4 died of disease relapse after transplantation. The transplant-related deaths were due to transplant-related infection (8 of 81), GVHD (2 of 81), and organ toxicity (2 of 81). The probability of overall survival (OS) was 80.2%. A higher dose of cyclophosphamide combined with fludarabine conditioning in UCBT was an effective curative method for treatment of hematologic disorders and could enhance the engraftment of umbilical cord blood stem cells, promote post-transplant immune reconstitution, and improve OS.

Percutaneous transluminal balloon angioplasty (PTA) is the main treatment option for Budd–Chiari syndrome (BCS) with inferior vena cava (IVC) obstruction. However, IVC rupture caused by PTA has never been reported. Between August 2004 and December 2016, a consecutive cohort of 617 BCS patients with obstructed IVC who underwent PTA with or without stent placement were reviewed retrospectively to identify IVC rupture. Pre- and post-procedural imaging data, clinical and procedural technical data were analyzed. Of the 617 BCS patients, five patients had IVC rupture caused by PTA (0.81%). Four of these patients had retroperitoneal, intra-hepatic IVC rupture without extravasation into abdominal cavity which was successfully managed conservatively. One patient had supra-hepatic IVC rupture into the pericardial cavity which was surgically treated. IVC rupture is a rare complication of PTA treatment of BCS and most commonly located at the intra-hepatic IVC caused by oversized balloons which does not require additional treatment.

Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

Aortic aneurysm and aortic dissection are life-threatening events with greater than 20% of all thoracic aortic aneurysms having a genetic basis for disease. This estimation of the genetic contributions to aortic dissection may actually be an underestimate secondary to silent thoracic aneurysms being undiagnosed and an under-utilization of genetic testing in the clinical arena. There are syndromic conditions with systemic manifestations of disease and non-syndrome genetic conditions with aortic aneurysms where there are no outward signs of disease. It is important for cardiologists, cardiovascular surgeons and other members of the multi-disciplinary team to have a good understanding of major features, diagnosis, surveillance and management guidelines of these genetic conditions to provide optimal care to these individuals.

Brucellosis is a neglected zoonosis. It causes acute febrile illness and a potentially debilitating chronic infection in humans, and livestock infection has substantial socioeconomic impact. Over the past two decades, improvements have been made to better understand the various aspects of human and animal brucellosis. Meanwhile, especially in the developing world, immense challenges that remain in controlling and eradicating brucellosis are novel diagnostics tools and efficacious vaccines. Here, we will focus on the remarkable issues on epidemiological survey, as well as the priority and challenge of brucellosis in China. Brucellosis will be controlled with meaningful collaboration between local and public partnerships effectively applying a One Health framework.

Summary Background & aims The Global Leadership Initiative on Malnutrition (GLIM) released new universal criteria for diagnosing and grading malnutrition, and calls for further investigations not only in different clinical setting but also in GLIM itself including reference value, combination and weight of different GLIM criteria. This study aimed to weigh the GLIM criteria and develop a scored-GLIM system, and then validate as well as evaluate its application in nutritional assessment and survival prediction for patients with cancer. Design A total of 3547 patients in the primary cohort and 415 patients in the validation cohort were included in the study. Patients’ nutritional status were retrospectively assessed using the GLIM criteria. Kaplan–Meier survival curves and multivariate Cox regression analyses were performed to analyze the association between nutritional status and overall survival (OS). A nomogram was produced to quantify the GLIM criteria and develop the scored-GLIM system. C-index, receiver operating characteristic (ROC) curve and calibration curve analyses were performed to validate the predictive accuracy and discriminatory capacity of the scored-GLIM. Finally, a decision curve was applied to assess the clinical utility of the scored-GLIM system. Results In the primary cohort, 70.3% of patients were diagnosed as malnutrition. The malnutrition severity grading according to the GLIM criteria were associated with the prognosis of patients with cancer (HR 1.42, 1.23 to 1.65 for moderate malnutrition; HR 1.80,1.84 to 2.09 for severe malnutrition). The weight of each GLIM criteria was calculated, and unintentional weight loss was the most determining factor acting upon mortality (HR 1.82, 1.64 to 2.10 for stage II and HR 1.50, 1.31 to 1.73 for stage I). A nomogram was constructed by four factors of GLIM to weigh the GLIM criteria. The areas under the ROC curve were 65.3 (1-year ROC) and 65.5 (3-year ROC), and the C-index was 0.62, and the calibration curves fitted well. Decision curve analysis demonstrated the clinical usefulness of the scored-GLIM system. Conclusion The accuracy and net clinical benefit of scored-GLIM system were similar to scored-PG-SGA but higher than GLIM both in nutrition assessment and in survival prediction for patients with cancer. These findings, along with its time-savings advantages over scored-PG-SGA, suggest scored-GLIM be a better nutritional assessment tool.

Nonintubated video-assisted thoracic surgery (VATS) strategies are gaining popularity. This review focuses on noninutbated VATS, and discusses advantages, indications, anesthetic techniques, and approaches to intraoperative crisis management. Advances in endoscopic, endovascular, and robotic techniques have expanded the range of surgical procedures that can be performed in a minimally invasive fashion. The nonintubated thoracoscopic approach has been adapted for use with major lung resections. The need for general anesthesia and endotracheal intubation has been reexamined, such that regional or epidural analgesia may be sufficient for cases where lung collapse can be accomplished with spontaneous ventilation and an open hemithorax.

Budd-Chiari syndrome (BCS) is a rare disease characterized by the obstruction of hepatic venous outflow due to occlusion of the hepatic vein (HV) or the inferior vena cava (IVC). The pathophysiology of IVC and HV membranous transformation, which can form in isolation or simultaneously, remains unclear in patients with combined-type BCS. Here we report three cases of patients with BCS demonstrating conversion from HV-type to combined-type. Three patients with only HV-type BCS underwent percutaneous balloon angioplasty (PTA) of the obstructed HV. During follow up, membranous transformation of the IVC was observed. This condition was subsequently treated with PTA of the IVC. These cases demonstrate that HV-type BCS may convert to combined-type BCS.

Combinations of bortezomib (Velcade), cyclophosphamide and dexamethasone have shown significant efficacy and safety for patients of newly diagnosed multiple myeloma (NDMM). In this study, we compared the efficacy and safety of modified VCD regimens with novel changes in bortezomib dose and schedule for NDMM. Eighty-five NDMM patients from multiple centers were randomly assigned to a high-dose (1.6 mg/m2) (group A) or a low-dose (1.3 mg/m2) (group B) bortezomib, administrated on days 1, 6, 11, and 16 subcutaneously in a 4-week cycle for nine cycles, combined with 40 mg dexamethasone on bortezomib days and cyclophosphamide 300 mg/m2 on days 1–3 intravenously. After four cycles, complete response (CR) or better in group A (43.6%) was higher than that in group B (12.8%) (P = 0.002). During induction, for patients with R-ISS stage III, the CR or better rate in group A was superior to that in group B (P = 0.01). Of patients

To explore the effect of interventional embolization treatment for hydrosalpinx on the outcome of in vitro fertilization and embryo transfer (IVF-ET). During the period from January 2013 to January 2015, a total of 129 patients with unilateral or bilateral hydrosalpinx were treated with IVF-ET and selected for retrospective analysis. Seventy-three patients (intervention group) with unilateral or bilateral hydrosalpinx were treated with fallopian tube embolization, which was followed by IVF-ET. During the same period, 56 patients (control group) with unilateral or bilateral hydrosalpinx directly received IVF-ET without receiving any treatment for hydrosalpinx. The clinical pregnancy rate of the control group was significantly lower than that of the intervention group (P

Budd-Chiari syndrome (BCS) is an uncommon disorder defined as an obstruction of the hepatic venous outflow. Percutaneous transluminal balloon angioplasty is a less invasive treatment option for BCS patients. However, there are no reports regarding inferior vena cava (IVC) rupture caused by perforation route through a collateral vein during treatment of BCS. Here, we report a male patient with BCS who had a long segmental obstruction of the IVC and its collateral vessels. Here, IVC rupture occurred at the distal end of the obstructed IVC during a percutaneous angioplasty; the rupture was repaired successfully with an endovascular stent graft.

As one of the most troublesome complications in patients with chronic renal disease, the etiology of uremic pruritus remains unknown, and the current therapeutic approaches are limited and unsatisfactory. To identify potential biomarkers for improving diagnosis and treatment and obtain a better understanding of the pathogenesis of uremic pruritus, we compared serum metabolome profiles of severe uremic pruritus (HUP) patients with mild uremic pruritus (LUP) patients using ultraperformance liquid chromatography-quadruple time-of-flight mass spectrometry (UPLC-QTOF MS). Partial least squares discriminant analysis (PLS-DA) showed that the metabolic profiles of HUP patients are distinguishable from those of LUP patients. Combining multivariate with univariate analysis, 22 significantly different metabolites between HUP and LUP patients were identified. Nine of the 22 metabolites in combination were characterized by a maximum area-under-receiver operating characteristic curve (AUC = 0.899) with a sensitivity of 85.1% and a specificity of 83.0% distinguishing HUP and LUP. Our results indicate that serum metabolome profiling might serve as a promising approach for the diagnosis of uremic pruritus and that the identified biomarkers may improve the understanding of pathophysiology of this disorder. Because the 9 metabolites were phospholipids, uremic toxins, and steroids, further studies may reveal their possible role in the pathogenesis of uremic pruritus.

Delayed hematopoietic recovery and increased rate of engraftment failure limit the use of umbilical cord blood transplantation (UCBT). We describe a case of severe aplastic anemia treated by UCBT combined with mesenchymal stem cells. Our case reveals that infusing mesenchymal stem cells early (about 40 days) after UCBT may promote hematopoietic recovery. This experience will guide clinical scientists, especially hematologists, to deal with similar situations and encourage them to widen this strategy.

The treatment of myelodysplastic syndromes (MDS) involves improving patient survival and quality of life (QoL) and decreasing the likelihood of progression to AML. Although the treatment outcomes of MDS remain unsatisfactory, few comparative studies have been performed while comparing the outcomes of low-risk and intermediate-risk patients treated with supportive care and chemotherapeutics to those of patients treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Therefore, we designed a clinical control study to compare the outcomes of supportive care and chemotherapeutics versus allo-HSCT treatment in MDS patients. A total of 182 patients with MDS were enrolled in the study, including 91 in the no-HSCT (control) group and 91 in the allo-HSCT group. The complete remission (CR) rate in the allo-HSCT group was significantly higher than that in the control group (53.8% vs. 33.0%; P 0.05). The QoL of patients in the HSCT group was much higher than that in the control group (53.8% vs. 37.4%; P 0.05). The overall survival (OS) rates were 79.0% and 56.0% (P 0.05) in the HSCT group and the control group, respectively. In conclusion, a high-dose fludarabine (Flu), busulfan (Bu), cyclophosphamide (CTX)-based conditioning regimen was well tolerated and significantly speeded hematopoietic recovery. In addition, this regimen increased procedure-related toxicity and improved QoL and OS.

The prognosis for patients with Chronic Myelogenous Leukemia (CML) in Blastic Crisis (BC) is poor, with a median survival of only 3-6 months. Blast crisis (BC) is highly refractory to therapy and has a poor prognosis. To determine the efficacy of TKIs-II combined with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in CML BC, we present four consecutive, recent cases of CML BC in which TKIs-II were used before or after allo-HSCT. Patient 1, a 28-year-old male received a HSCT from a half-matched, related-donor. Patient 2, 3 received an HLAidentical unrelated-donor HSCT. To date, patients 1,2,3 and 4 have survived postprocedure for 22, 23, 21 and 25 months, respectively. We conclude that compared with imatinib, TKIs-II may reduce tumor burden more rapidly and thoroughly when administered before or after allo-HSCT and enhance the graft versus leukemia effect, prolonging the long-term survival of patients. We speculate that GVL and tumor burden are negatively correlated.

OBJECTIVES: The surgical outcome of neurogenic tumours arising at the thoracic apex remains largely undefined. In this retrospective study, we compared the efficacy and safety of thoracoscopic surgery and thoracotomy for neurogenic tumours at the thoracic apex in 63 patients who received surgical treatment between 1992 and 2012 at our medical centre. METHODS: Forty-four (69.8%) patients received thoracotomy (Group A) and 19 (30.2%) patients underwent video-assisted thoracoscopic surgery (Group B). Operative time, estimated blood loss (EBL), postoperative length of hospital stay and nervous system complications were recorded. RESULTS: The two groups of patients were comparable in demographic and baseline characteristics except that Group A patients had a significantly larger tumour size (mean, 4.9 ± 1.0 cm) than Group B patients (mean, 4.1 ± 1.2 cm; P = 0.01). The mean operative time was markedly greater for Group A (120.2 ± 41.2 min) than Group B (93.2 ± 34.5 min; P = 0.009). Group A had significantly greater EBL (245.23 ± 197.78 ml) than Group B (117.4 ± 138.2 ml; P < 0.001). Total tumour resection was achieved in all patients and all neurogenic tumours were benign. The mean length of postoperative hospital stay was markedly longer in Group A (7.0 ± 2.1 days) than Group B (4.8 ± 2.0; P < 0.001). Postoperatively, brachial plexus injury was found in 1 patient (2.3%) in Group A and 4 patients (21.1%) in Group B (P = 0.026). CONCLUSIONS: Though thoracoscopic surgery is associated with diminished blood loss, reduced operative time and shortened hospital stay, it has a markedly increased incidence of brachial plexus injury.

OBJECTIVES Station 3A nodes have been commonly neglected in surgical practice. This retrospective study collected information on the incidence and risk factors of Station 3A node to ascertain the prognostic role of 3A nodal involvement. METHODS A total of 180 consecutive pN2 (stage IIIa) non-small-cell lung cancer (NSCLC) cases who underwent systemic lymphadenectomy and contained Station 3A nodes were enrolled. Survival rates were calculated according to the final pathology of Station 3A lymph node: Station 3A node (+) and Station 3A node (-). Statistical analysis was conducted using Kaplan-Meier and Cox regression models. RESULTS Station 3A nodal metastasis was validated in 32 cases, and the incidence of Station 3A node involvement was 17.8%. Station 3A nodes involvement was strongly associated with the metastatic status of Station 4R nodes and histological nature of pulmonary cancer. The overall 3-year survival was 53% and median survival time was 40.6 months. The 3-year survival difference was significant between Station 3A node (-) and Station 3A node (+) (63 vs 22%, χ(2) = 16.426, P < 0.001). Moreover, the overall 3-year survival was closely related with the number of involved nodal zones (χ(2) = 31.156, P < 0.001). Multivariate analysis showed two statistically significant risk factors for survival including metastasis of Station 3A node and the number of positive nodal zones (hazard ratios [HR]: 2.702; 95% confidence intervals [CI]: 1.008-7.242; P = 0.027; and HR: 7.404; 95% CI: 3.263-16.936, P < 0.001, respectively). CONCLUSIONS The involvement of Station 3A lymph nodes predicts poor prognosis of right-sided stage pIIIa-N2 NSCLC patients. Therefore, systemic lymphadenectomy for right-sided cancers should include Station 3A nodes when ascertaining a complete resection.

The present study was designed to investigate the effect of thymosin α1 (Tα1) administration in infective recipients of hematopoietic stem cell transplantation (HSCT) for hematologic malignancies. Eight patients were enrolled in our study, including seven allo-HSCT patients and one auto-HSCT patient. These patients were allocated randomly into the treatment group (four cases) and control group (four cases). Tα1 was used in the treatment group to test its effectiveness in infection control. The concentrations of cytokines IFN-γ, IL-2, IL-4, IL-10, and IL-12 were observed, and the levels of CD3(+), CD4(+), and CD8(+) T cells, as well as of CD4(+)/CD8(+) and CD4(+)/CD25(+) regulatory T cell (Treg) were measured. When Tα1 was administered for 2 weeks, the concentrations of these cytokines were increased after 1 month in the treatment group. Interestingly, the levels of IFN-γ, IL-2, IL-10, and IL-12 were increased in the treatment group more than those in the control group, whereas there were no significant differences between the treatment and control group in the levels of CD3(+), CD4(+), and CD8(+) T cells, or in CD4(+)/CD8(+) or CD4(+)/CD25(+) Treg cells. Notably, Tα1 administration did not cause acute or chronic graft versus host disease (GVHD). We conclude that Tα1 administration is safe and may impact favorably on immune function, and that it may improve resistance to infection and induce immunotolerance without GVHD.

Acute myeloid leukemia (AML) is the most common type of adult leukemia for which cytosine arabinoside-based chemotherapy is the main treatment. Single nucleotide polymorphisms within the nucleotide excision repair pathway may alter the susceptibility of leukemia cells to chemotherapy. We investigated the roles of six single nucleotide polymorphisms (ERCC5rs76871136, ERCC5rs77569659, ERCC5rs873601, XPCrs2228000, XPCrs2228001, and XPCrs1870134) in the nucleotide excision repair pathway in influencing the outcome of patients with AML treated with cytosine arabinoside-based chemotherapy. One hundred fifty-one patients with AML in a Chinese population were enrolled in this study. Genotypes were determined by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. We found that the distribution of three genotypes of XPCrs1870134 significantly differed in the cytogenetic risk groups (P = 0.04). A statistically significant correlation between polymorphisms of XPCrs2228001 and gender was found among the gender groups (P = 0.03). Moreover, patients carrying at least one variant allele (XPCrs2228001AA+CC) were more likely to respond better than those who did not carry a variant. However, no significant association was detected between polymorphisms in ERCC5 and treatment response. These findings suggest that XPC polymorphisms are important markers for the outcome of patients with AML in the Chinese population.

The surgical treatment of pulmonary aspergilloma is challenging and controversial. This study was designed to evaluate the clinical profile, indications and surgical outcomes of pulmonary aspergilloma operated on in our institute. A total of 256 patients with pulmonary aspergilloma underwent surgical treatment from 1975 to 2010. The patients were divided into two groups: Group A (simple aspergilloma, n = 96) and Group B (complex aspergilloma, n = 160). The principal underlying lung disease was tuberculosis (71.1%). The surgical procedures consisted of 212 lobectomies in both groups; eight cavernoplasties, 10 bilobectomies, 16 pneumonectomies and six thoracoplasties in Group B; four segmentectomies and six wedge resections in Group A. Postoperative complications occurred in 40 patients (15.6%). The major complications were residual pleural space (3.9%), prolonged air leak (3.1%), bronchopleural fistula (1.6%), excessive bleeding (1.6%), respiratory insufficiency (1.9%) and empyema (1.2%). No intraoperative deaths occurred. The overall mortality within 30 days post-operation was 1.2%, occurring only in Group B. There was no statistically significant difference in the postoperative morbidity between Groups A and B (P = 0.27). With the good selection of patients, meticulous surgical techniques and good postoperative management, aggressive surgical treatment with anti-fungal therapy for pulmonary aspergilloma is safe and effective, and can achieve favourable outcomes.

Purpose To investigate the prognostic role of radical lymph node dissection in treatment for pulmonary Low Grade Malignant Tumors (LGMTs); specifically, on the extent of nodal removal and its impact on long-term survival. Methods A total of 93 LGMTs cases underwent surgical resection and were histopathologically confirmed. Overall survival rates and disease-free survival were respectively calculated according to the extent of lymph node resection and histopathological grades of tumors. Risk factors of nodal involvement and survival predictors were calculated via multivariate analysis. Life table, Kaplan–Meier, and Cox regression models were used for the statistical analysis. Results Thirty-eight cases of carcinoid, 17 adenoid cystic carcinomas, and 38 mucoepidermoid carcinomas were included in the current study. Twenty-one cases were high-grade and 72 were low-grade . A total of 813 lymph nodes were removed, at an average of 8.7±5.4 nodes per patient. The numbers of harvested nodes were 11.8±4.5, in the study group via radical nodal removal and 4.0±2.4 nodes per patient in the nodal sampling group. Eleven cases showed lymph nodal involvement (5 mediastinal and 6 hilar lymph node metastasis). No significant differences of overall survival was found among the different histological types ( p =0.939), or the extent of nodal removal ( p =0.971). Meanwhile, there was a significant difference of disease-free survival (DFS) rates according to the extent of nodal removal (5-YS: 97% of radical nodal dissection vs. 78% of nodal sampling, p =0.038). Overall survival and disease-free survival were closely associated with histological grading (OS: 78% of high grade vs. 97% of low grade, p =0.001; DFS: 57% of high grade vs. 97% of low grade, p Conclusions Radical lymph node dissection improved disease-free survival for pulmonary low-grade malignant tumors, although no obvious improvement on overall survival was noticed. Histological grade was the most important prognostic factor in LGMTs.

Diastolic heart failure (DHF) is characterized by symptoms including reduced ventricular relaxation and compliance, resulting in congestion of pulmonary and systemic circulation. The curative effects of regular cardiac agents are ineffective. Thus, new agents are required to treat chronic cardiac failure. The aim of the present study was to examine the clinical effects of the combined treatment by optimal dose of furosemide (20 mg/day) and spironolactone (40 mg/day) on elderly patients with diastolic heart failure (DHF) [New York Heart Association (NYHA) 1–2 grade]. A total of 93 patients diagnosed with DHF between February, 2013 and February, 2014 were enrolled in the present study. The patients were randomly divided into the furosemide group (20 mg/day, n=27), optimal dose group (20 mg/day furosemide+40 mg/day spirolactone, n=36), and large dose group (40 mg/day furosemide+100 mg/day spirolactone, n=30). Following treatment for one month, a comparison and analysis of the NYHA class, left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDD), left ventricular wall segmental motion among the three groups were performed. The re-hospitalization rate of heart failure and incidence of electrolyte disorder among the three groups was compared and their differences analysed. Compared with pretreatment, the NYHA classifications of the three groups after treatment were reduced and differences were statistically significant (P0.05). Compared with pretreatment, LVEF of the optimal dose group increased, LVEDD decreased, and the average systolic myocardial peak velocity and early diastolic myocardial peak velocity of ventricular wall motion were reduced, with differences being statistically significant (P0.05). Improvement of the optimal dose group following treatment was more significant than the remaining two groups, and differences were statistically significant (P

Jian Cheng1,*, Ying Zhou1,*, Baoan Chen1, Jun Wang1, Guohua Xia1, Nan Jin1, Jiahua Ding1, Chong Gao1, Gouming Chen2, Yushan Miao2, Weilan Li2, Ziling Liu3, Xuemei Wang11Department of Hematology, Zhongda Hospital, Medical School, Southeast University, Nanjing, People’s Republic of China; 2Department of Pharmacy, Zhongda Hospital, Medical College, Southeast University, Nanjing, People’s Republic of China; 3The First Hospital of Jilin University, Changchun, Jilin, People’s Republic of China *These authors have contributed equally to this workObjective: To investigate the effect of magnetic nanoparticles (MNPs) of Fe3O4 combined with cyclosporin A (CsA) on acute graft-versus-host disease (aGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in murine models.Methods: BALB/c mice preconditioned with total-body irradiation generated aGVHD and then were followed with allo-HSCT from allogeneic C57BL/6. Recipient mice were randomly divided into five groups and then given different supportive care and followed up. The physical signs and median survival time (MST) were recorded, peripheral blood cell counts were assessed, and histological changes of the main tissues were evaluated with hematoxylin-eosin staining. Furthermore, fluorescence polarization immunoassay was used to monitor the concentration of CsA.Results: The irradiated-only mice developed typical aGVHD, and the typical signs of aGVHD in the skin, liver, and intestine were observed by histopathological examination. Both CsA alone and in combination with Fe3O4 MNPs significantly prolonged the MST of recipient mice compared with both the control and the Fe3O4 MNPs groups. Notably, a combination of CsA with Fe3O4 MNPs can elevate the peripheral white blood cells and alleviate the symptoms of GVHD and the pathological damage after allo-HSCT. In addition, the concentration of CsA was higher in plasma, heart, liver, and spleen of recipient mice with supporting care of the combination of CsA with Fe3O4 MNPs than with CsA alone.Conclusion: Taken together, Fe3O4MNPs may be used as a carrier of immunosuppressive agents to alleviate GVHD after allo-HSCT in murine models.Keywords: allogenetic stem cell transplantation, mice, HSCT

Background Bronchiectasis is one of the common diseases diagnosed in the world. No major improvement for the treatment approaches and limited efficacy promote a big challenge for management of this disease. Video-assisted thoracoscopic surgery (VATS) offers a new choice for the treatment of bronchiectasis. The purpose of this study was to present our experience of VATS for bronchiectasis and to compare this with thoracotomy in our institution. Methods We reviewed the medical records of patients who underwent VATS lobectomy and general lobectomy for bronchiectasis between January 2005 and December 2009. Results A total of 279 patients underwent thoracotomy, 52 patients underwent attempted VATS lobectomy. Fifty-two patients from 279 patients for thoracotomy were selected and compared with the VATS group. Pleural adhesion was observed in 15 patients (28.8%) in VATS. The VATS lobectomy was converted to open thoracotomy in 7 patients. There was no difference in the blood loss and median operative time between the two groups, but the patients with VATS had shorter length of stay in hospital ( p = 0.045), fewer complications ( p = 0.039) than those with thoracotomy. Forty-nine (94%) and 46 (88%) patients fully recovered after operation by VATS and thoracotomy, respectively. Conclusions Video-assisted thoracoscopic lobectomy in localized bronchiectasis is a safe and more efficient procedure in selected patients with better recovery.

Background and Objective: Allogeneic hematopoietic cell transplantation (allo-HSCT) is a potent procedure for the treatment of hematologic diseases, yet it is associated with high risks of treatment-related complications. Except for transplant-related organ toxicities, renal insufficiencies which emerge earlier significantly limit patients’ long survival. To analyze risk factors for acute kidney injury (AKI), we conducted a retrospective cohort study of 96 patients undergoing HSCT. Methods During the first 100 days after allo-HSCT, all patients were evaluated for renal function by measuring serum creatinine clearance and glomerular filtration rate (GFR) with a classification below: Grade 0 (＜25%, decline in creatinine clearance), Grade 1 (≥25% decline in creatinine clearance but ＜ 2-fold increase in serum creatinine), Grade 2 (≥2-fold rise in serum creatinine but no need for dialysis), and Grade 3 (≥2-fold rise in serum creatinine and need for dialysis). Cox regression model was used to calculate the hazard ratios (HRs) of demographic data, clinical variables, and risk factors for AKI. Results: Twenty-eight (29.2%) patients occurred Grades 1-3 renal dysfunction (Grade 1, 14 patients; Grade 2, 12 patients; Grade 3, 2 patients), and ratios of early kidney injury increased in high-risk malignancy group (HR=2.945, 95% confidence interval (CI)=1.293-6.421), patients treated with myeloablative conditioning regimen (HR=2.463, 95% CI=1.757-4.320), and patients with acute GVHD (HR=3.553, 95% CI=1.809-6.978), sepsis (HR=3.215, 95% CI=1.189-6.333), or hepatic veno-occlusive disease (VOD) (HR=3.487, 95% CI=1.392-6.524). Whereas, HLA histocompatibility showed no striking increased risk for acute renal injury (HR=1.684, 95% CI=0.648-4.378). The survival rate was lower in patients with severe nephrotoxicity (21.4%) than in patients without nephrotoxicity (70.6%) (P=0.001). Conclusions: Nephrotoxicity is the primary risk factor for AKI, severely impacting on survival. Sorts of risk factors mentioned will be useful for evaluation for kidney function of patients undergoing allo-HSCT.

Bao-An Chen1, Nan Jin1, Jun Wang1, Jiahua Ding1, Chong Gao1, Jian Cheng1, Guohua Xia1, Feng Gao1, Yin Zhou1, Yue Chen1, Guina Zhou1, Xiaomao Li2, Yu Zhang3, Men Tang3, Xuemei Wang31Department of Hematology, Zhongda Hospital, Clinical Medical School, Southeast University, Nanjing, People’s Republic of China; 2Department of Physics, University of Saarland, D-266041 Saarbruechen, Germany; 3National Key Laboratory of Bioelectronics (Chien-Shiung Wu Laboratory), Southeast University, Nanjing, People’s Republic of ChinaAbstract: We investigated the effect of magnetic nanoparticles of Fe3O4 (Fe3O4-MNPs) on the mice immune system. Imprinting control region (ICR) mice were assigned randomly into four groups and treated with normal saline or low, medium, or high doses of Fe3O4-MNPs, respectively. After intravenous administration of Fe3O4-MNPs for 72 hours, the peripheral T cells and the induction of primary immune responses in mice were investigated by flow cytometry and determined using enzyme-linked immunosorbent assay, respectively. The results showed that the ratio of spleen to body weight was not different between the experimental groups and control group (P > 0.05). The lymphocyte transformation rates in the suspension of spleen were higher in low-dose group than those in the control group (P < 0.05), while the proliferation of splenocytes was low in the medium and high groups when compared to the control group (P < 0.05). In peripheral blood, both the proportions of subset CD4+ and CD8+ T lymphocytes in the low-dose group were higher than those in the control group, whereas there was no difference in the number of CD4+ T cells between the medium- and low-dose groups. Interestingly, the Fe3O4-MNPs enhanced the production of interleukin-2 (IL-2), interferon-γ, and IL-10 but did not affect the production of IL-4 in peripheral blood. It is concluded that Fe3O4-MNPs could influence immune functions of normal ICR mice in a dose-dependent manner.Keywords: magnetic nanoparticle of Fe3O4, immune function, splenocyte proliferation, cytokine

Background: While benign duodenal tumours are rare compared with malignant tumours, they comprise a wide variety of pathologies. Despite their diagnostic challenge, the optimal management of benign duodenal tumours remains undefined. We aimed to review the diagnosis and surgical treatment of benign duodenal tumours. Methods: Records of all patients with post-operative pathological diagnosis of benign duodenal tumour were retrieved. Information on clinical presentations, diagnostic methods, tumour locations, surgical approaches, pathological results and patient outcomes were analysed. Results: The operative spectrum included local resection in 8 cases, segmental duodenectomy in 1 case, subtotal gastrectomy in 1 case, papilla resection with sphincteroplasty in 3 cases and pancreaticoduodenectomy in 5 cases. The post-operative pathology results indicated 5 cases of adenoma, 2 cases of tubular adenoma, 2 cases of villous adenoma, 2 cases of tubulovillous adenoma, 2 cases of hamartoma and 1 case each of hamartomatous polyp, Brunner's adenoma, adenomyoma, fibromatosis and ectopic pancreas. Post-operatively, one patient died of unrelated disease, one case was lost in follow-up and the remaining patients survived recurrence-free with a good quality of life. Conclusion: The presentation of benign duodenal tumours is non-specific, with upper abdominal discomfort and upper gastrointestinal bleeding as common symptoms. Surgical resection is the preferable therapeutic choice with satisfactory prognosis.

BACKGROUND Immunoglobulin A nephropathy (IgAN) is associated with genetic and environmental factors, and undergalactosylation of IgA1 in the serum is considered to be a contributor to pathogenesis of IgAN. The present study was conducted to detect the galactose- (Gal) deficient IgA1 level in Chinese IgAN patients and their family members. METHODS Sixty-three IgAN patients were enrolled, where 32 first-degree relatives of 19 patients and 44 spouses of 44 patients were recruited. Healthy blood donors (n = 39) were used as normal controls. Biotinylated HAA (Helix aspersa) was utilized to detect the Gal-deficient IgA1 in enzyme-linked immunosorbent assay (ELISA). All the results were corrected by serum IgA1 concentration. RESULTS Compared with normal controls, the sera IgA1 of patients and their first-degree relatives demonstrated increased Gal-deficient IgAl level (0.17 +/- 0.09 versus 0.10 +/- 0.04, P = 0.001; 0.14 +/- 0.07 versus 0.10 +/- 0.04, P = 0.028); no significant difference between patients and their first-degree relatives was detected (0.17 +/- 0.09 versus 0.14 +/- 0.07, P = 0.127). In contrast, serum Gal-deficient IgA1 level of IgAN patients was higher than their counterpart spouses and normal controls (0.18 +/- 0.13 versus 0.14 +/- 0.09, P = 0.009; 0.18 +/- 0.13 versus 0.10 +/- 0.04, P = 0.001), while that of patients' spouses was comparable with normal controls (0.14 +/- 0.09 versus 0.10 +/- 0.04, P = 0.075). There was no correlation between clinicopathological data and serum Gal-deficient IgA1 level. CONCLUSION The patients with IgAN and their first relatives showed significant higher Gal-deficient IgA1 level than healthy controls, whereas patients' spouses were the same as healthy controls. It can be suggested that the Gal-deficient IgA1 might be inherited in Chinese patients with IgAN.

Acute kidney injury (AKI) is a common early complication in patients with hematopoietic SCT (HSCT). However, there are limited data about the incidence and risk factors of AKI in patients with nonmyeloablative HSCT. We conducted a multicenter, retrospective cohort study of 62 patients from three institutions who were treated with similar protocols for nonmyeloablative HSCT. AKI was classified according to the Acute Kidney Injury Network criteria. It was shown that 29% of the patients developed AKI in the first 100 days after nonmyeloablative HSCT. The risk factor at baseline for AKI was incomplete HLA-matched transplant (odds ratio (OR) 3.6; 95% confidence interval (CI) 1.1-13.0). Complications such as acute GVHD, veno-occlusive disease of liver and sepsis were also associated with the development of AKI (OR 12.1; 95% CI 2.4-62.4). AKI was significantly associated with mortality (OR=4.7; 95% CI 1.9-11.5). We concluded that AKI is a very common complication in patients with nonmyeloablative HSCT, which is associated with incomplete HLA-matched transplant and complications, and has an important impact on the patients' first year of survival.

To compare survival and outcomes of pulmonary resection for elderly NSCLC patients with that of younger controls in China.A database which included 4792 NSCLC patients who received complete surgery from 1985 to 2005 was used. The elderly patients (or=70) were matched 1:1 to controls (70) by 5 variables: gender; stage; histology; pulmonary resection types; adjuvant chemotherapy. The long-term survival rates, the operative mortality and short-term death after surgery were compared.There were 1304 patients: 652 cases wereor=70. The 5-year OS of elderly was 39%; that of the controls was 45% (p=0.06). Operative mortality rate between elderly and the controls was similar (9/652 vs 4/652 p=0.16) but the short-term death within 2 months after the surgeries were different (23/652 vs 7/652 p=0.003). The elderly with lobectomy had a worse 5-year OS than controls (42% vs 46% p=0.05), but the 5-year OS was similar for patients who received pneumonectomy (24% vs 36% p=0.40) and the limited resections (46% vs 39% p=0.27). The 5-year OS in patients who received adjuvant chemotherapy were similar (49% vs 44% p=0.10).Elderly have the similar long-term OS with the controls. They should not be denied the curative surgery and adjuvant chemotherapy based on their chronologic age. However, elderly patients had a higher risk of short-term death after the surgery, which suggests that elderly be given more intensive care after the surgery.

Background: Alport syndrome (AS) and thin basement membrane nephropathy (TBMN) are heterogeneous renal hereditary diseases. Mutations of COL4A3 and COL4A4 genes were reported to be the underlying pathogenicity in both diseases. However, the mechanism of the same mutation causing totally different clinical processes and outcomes in AS and TBMN is still not clear. Subjects and Methods: Mutations of all coding exons of COL4A3 and COL4A4 were screened in a patient with autosomal recessive Alport syndrome (ARAS) of a Chinese Han consanguineous family by means of PCR and direct sequencing. Furthermore, the identified mutation was validated by restriction endonuclease AvaII in all 20 members in his family, as well as 46 patients with TBMN, 2 patients with AS from another two families, and 50 healthy controls. Results: A novel missense mutation (3725G>A, G1242D) in exon 42 of COL4A3 was identified in the proband in the homozygous form. This pathogenic mutation was demonstrated in all carriers who presented with hematuria or mild proteinuria in the heterozygous form, whereas it was not detected in others whose urinalysis was normal within the family. In addition, 10 polymorphisms, including 1 non-glycine missense variant and 9 neutral polymorphisms, were detected in COL4A3/COL4A4. Conclusion: The novel mutation (3725G>A, G1242D) of COL4A3 was the underlying pathogenic role in the homozygous form in ARAS and in the heterozygous form in TBMN within an identical family. The result provided a potentially useful clue for the functional investigation of COL4A3 in these two hereditary glomerular disorders.

Background: Renal insufficiency is a common complication early after hematopoietic stem cell transplantation (HSCT). Over the past several years, significant advancement has been achieved in HSCT, especially in nonmyeloablative stem cell transplantation. Compared with traditional HSCT, nonmyeloablative HSCT employs significantly lower doses of chemoradiotherapy and lower toxicity. The current study evaluated renal insufficiency during the first 100 days in patients with chronic myelocytic leukemia (CML) who underwent nonmyeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT) in a single center. Methods: A total of 26 consecutive patients with CML received nonmyeloablative allo-PBSCT from 2002 to 2005 in Zhong Da Hospital. The average age of the patients was 40.2 ± 8.2 years. Renal function was measured by serum creatinine concentration and estimated glomerular filtration rate (GFR) during the first 100 days after nonmyeloablative allo-PBSCT. Renal dysfunction was classified as follows: grade 0 (Results: All the patients were successfully engrafted. Of the 26 patients, 10 (38%) patients had some degree of renal dysfunction (grade 1, 5 patients; grade 2, 4 patients; grade 3, 1 patient). They developed ARF at an average of 32.8 ± 4.0 days after transplantation. No significant difference was observed in terms of age, baseline serum creatinine, albumin and hemoglobin between the patients with ARF and without ARF. Renal dysfunction was associated with significantly higher frequencies of sepsis and hepatic veno-occlusive disease (VOD, p < 0.01, respectively). The overall mortality rate at the end of 100 days was 19% (5/26). The mortality rate for patients with ARF was significantly higher than those without ARF (p < 0.001). Conclusion: During the first 100 days following nonmyeloablative allo-PBSCT in patients with CML, a 38% incidence of renal dysfunction and a 19% of ARF were found, which were much less than previous studies. Sepsis and VOD were significantly correlated with the development of renal dysfunction. Severe nephrotoxicity was associated with the increase in mortality.

To assess the 5′ CpG island methylation of Fanconi anemia, complementation group F (FANCF) gene in epithelial ovarian cancer (EOC) tissues and normal ovarian tissues and to investigate the relationship between FANCF methylation and clinicopathologic features and prognosis of EOC. The experiment was performed with 112 EOC tissue samples (case group) and 60 normal ovarian tissues (control group). With methylation-specific polymerase chain reaction (MSP), FANCF methylation status of cases and controls was assessed. And the association between FANCF methylation and the clinicopathological features of EOC was investigated with univariate survival analysis and Cox regression model analysis. The methylation-positive rate of the case group was significantly higher than that of the control group (P = 0.015). The FANCF promoter methylation rates showed significant differences in the comparisons stratified by age, International Federation of Gynecology and Obstetrics (FIGO) staging, histopathological classification, and lymph node metastasis (all P < .05). Univariate survival analysis showed there were significant differences in mean survival time between the groups based on FIGO staging, histopathological classification, lymph node metastasis, and FANCF methylation (all P < .05). Cox regression model analysis suggested that FIGO staging and FANCF methylation were independent risk factors for EOC prognosis. CpG island methylation of FANCF gene promoter region is strongly associated with the susceptibility and clinicopathologic features of EOC. The FIGO staging and FANCF methylation are independent risk factors for EOC prognosis.

This study describes a method of gene delivery to pancreatic islets of adult, living animals by ultrasound targeted microbubble destruction (UTMD). The technique involves incorporation of plasmids into the phospholipid shell of gas-filled microbubbles, which are then infused into rats and destroyed within the pancreatic microcirculation with ultrasound. Specific delivery of genes to islet beta cells by UTMD was achieved by using a plasmid containing a rat insulin 1 promoter (RIP), and reporter gene expression was regulated appropriately by glucose in animals that received a RIP–luciferase plasmid. To demonstrate biological efficacy, we used UTMD to deliver RIP–human insulin and RIP–hexokinase I plasmids to islets of adult rats. Delivery of the former plasmid resulted in clear increases in circulating human C-peptide and decreased blood glucose levels, whereas delivery of the latter plasmid resulted in a clear increase in hexokinase I protein expression in islets, increased insulin levels in blood, and decreased circulating glucose levels. We conclude that UTMD allows relatively noninvasive delivery of genes to pancreatic islets with an efficiency sufficient to modulate beta cell function in adult animals.

Background Broncholithiasis is a rare disease with various clinical classifications. The aim of this study was to evaluate the imaging diagnosis and surgical treatment of broncholithiasis. Methods and Materials Forty-eight patients with broncholithiasis were enrolled in this retrospective study between January 1985 and December 2009. Patients were classified into intraluminal, transluminal, and extraluminal broncholith according to the anatomy between the calculus and the bronchial lumen confirmed by chest computed tomography (CT), bronchoscopy, and pathology after operation. Result Forty-eight patients were enrolled, with 33 males and 15 females. The sex ratio (male:female) was 2.2:1, and average age was 54.3 ± 13.6 years. There were 8, 19, and 21 patients in intraluminal, transluminal, and extraluminal broncholith group, respectively. Cough, hemoptysis, and chest pain were the most common symptoms. Four patients with intraluminal broncholith and two with transluminal broncholith underwent broncholith removal via bronchoscopy, and the other 42 patients underwent thoracotomy. Conclusion Bronchoscopy combined with CT examination is helpful in diagnosing and typing broncholithiasis. An optimal treatment method, either bronchoscopic removal of broncholithiasis or thoracotomy, according to the clinical typing and indications, is the key to improve the treatment effect.

We identified a novel gene ST13 from a subtractive cDNA library of normal intestinal mucosa in 1993, more studies showed that ST13 was a co-chaperone of Hsp70s. Recently we detected the ST13 gene expression in tumor tissue and adjacent normal tissue of the same colorectal cancer patient and investigated if the ST13 gene expression might have any prognostic value. Analysis was performed at molecular level by reverse transcription-PCR using real-time detection method. We measured two genes simultaneously, ST13 as the target gene and glyceraldehydes-3-phosphate dehydrogenase as a reference gene, in primary colorectal tumor specimens and tumor-adjacent normal mucosa specimens from 50 colorectal cancer patients. The expression levels of the ST13 gene were significantly decreased in primary tumors compared with adjacent mucosa (P

Objective: To investigate the relationship between co-deletion of p15/p16 genes and the prognostic significance in patients with non-small cell lung cancer (NSCLC). Methods: By using polymerase chain reaction (PCR), the loss of p15/p16 genes was examined in DNA samples from 140 NSCLC patients. Results: The rate of co-deletion in adenocarcinoma was significantly higher than that in squamous cell carcinoma (P 0.05). By a five years’ follow-up survey, the survival rate of NSCLC patients with co-deletion of p15/p16 genes was obviously lower than that of patients without co-deletion (P

We report a case of pulmonary adenosquamous carcinoma with a tumor thrombus in the left atrium. The left atrial tumor thrombus and lung cancer were removed via a right pneumonectomy and atriotomy under cardiopulmonary bypass. Simultaneous resection of a left atrial tumor thrombus and lung cancer can prevent systemic embolization, mitral obstruction, and sudden death, and improve the prognosis in selected patients.

The association between common variations (rs10937405, rs4488809) on 3q28 and lung cancer has been widely evaluated in various ethnic groups, since it was first identified through genome-wide association approach. However, the results have been inconclusive. To derive a more precise estimation of the relationship and the effect of factors that might modify the risk, we performed this meta-analysis. The random-effects model was applied, addressing heterogeneity and publication bias. A total of 10 articles involving 36,221 cases and 58,108 controls were included. Overall, the summary per-allele OR of 1.19 (95 % CI 1.14–1.25, P < 10−5) and 1.17 (95 % CI 1.10–1.23, P < 10−5) was found for the rs10937405 and rs4488809 polymorphisms, respectively. Significant results were also observed in heterozygous and homozygous when compared with wild genotype for these polymorphisms. Significant results were found in East Asians when stratified by ethnicity, whereas no significant associations were found among Caucasians. After stratifying by sample size, study design, control source and sex, significant associations were also obtained. In addition, our data indicate that these polymorphisms are involved in lung cancer susceptibility and confer its effect primarily in lung adenocarcinoma when stratified by histological subtype. Furthermore, significant associations were also detected both never-smokers and smokers for these polymorphisms. In conclusion, this meta-analysis demonstrated that rs10937405 and rs4488809 are a risk factor associated with increased non-small cell lung cancer susceptibility, particularly for East Asian populations.