Effect of a 3D-printed reconstruction automated matching system for selecting the size of a left double-lumen tube: a study protocol for a prospective randomised controlled trial.

INTRODUCTION: Lung isolation is primarily accomplished using a double-lumen tube (DLT) or bronchial blocker. A precise and accurate size of the DLT is a prerequisite for ensuring its accurate placement. Three-dimensional (3D) reconstruction technology can be used to accurately reproduce tracheobronchial structures to improve the accuracy of DLT size selection. Therefore, we have developed automatic comparison software for 3D reconstruction based on CT data (3DRACS). In this study, we aimed to evaluate the efficiency of using 3DRACS to select the DLT size for endobronchial intubation in comparison with using the 'blind' DLT intubation method to determine the DLT size, which is based on height and sex. METHODS AND ANALYSIS: This is a prospective, single-centre, double-blind randomised controlled trial. In total, 200 patients scheduled for lung resection using a left DLT will be randomly allocated to the 3D group or the control group at a 1:1 ratio. A 3DRACS will be used for the 3D group to determine the size of the DLT, while in the case of the control group, the size of the DLT will be determined according to patient height and sex. The primary outcome is the success rate of placement of the left DLT without fibreoptic bronchoscopy (FOB). The secondary outcomes include the following: successful intubation time, degree of pulmonary atrophy, grade of airway injury, oxygenation during one-lung ventilation, postoperative sore throat and hoarseness, and number of times FOB is used. ETHICS AND DISSEMINATION: Ethical approval has been obtained from our local ethics committee (approval number: SCCHEC-02-2022-155). Written informed consent will be obtained from all participants before randomisation, providing them with clear instructions about the purpose of the study. The results will be disseminated through peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER: NCT06258954.

The Diagnostic and Prognostic Value of EBUS-TBNA for Intrathoracic Metastasis in Previously Treated Patients With Head and Neck Cancer.

OBJECTIVE: The present study assessed the diagnostic and prognostic significance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for suspected intrathoracic metastasis after HNC treatment. METHODS: A retrospective analysis was conducted on 75 patients with a prior history of head and neck cancer treatment who underwent EBUS-TBNA for suspected intrathoracic metastases between March 2012 and December 2021. RESULTS: A total of 126 targeted lesions, including 107 mediastinal/hilar lymph nodes and 19 intrapulmonary/mediastinal masses, were sampled. The metastatic head and neck cancer (HNC) cases detected by EBUS-TBNA consisted of nasopharyngeal carcinoma (n = 24), oropharyngeal carcinoma (n = 3), hypopharynx carcinoma (n = 6), laryngeal carcinoma (n = 6), and oral cavity carcinoma (n = 6). Cases with negative EBUS-TBNA results consisted of tuberculosis (n = 9), sarcoidosis (n = 3), anthracosis (n = 9), and reactive lymphadenitis (n = 9). Six false-negative cases were found among the 75 patients with suspected intrathoracic metastases. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of the EBUS-TBNA procedure for metastatic HNC were 88.2, 100.0, 100.0, 80, and 92.0%, respectively. The diagnosis of HNC intrathoracic metastasis by EBUS-TBNA correlated with an adverse prognosis in terms of overall survival (OS) (P = .008). The log-rank univariate analysis and Cox regression multivariate analysis results indicated that the detection of metastatic HNC through EBUS-TBNA was a significant independent prognostic factor for patients with HNC who had received prior treatment. CONCLUSIONS: Endobronchial ultrasound-guided transbronchial needle aspiration is a safe, effective, and minimally invasive procedure for assessing suspected intrathoracic metastasis in HNC patients after treatment. The intrathoracic metastasis detected by EBUS-TBNA has crucial prognostic significance in previously treated HNC patients.

A novel technique of endonasopharyngeal ultrasound-guided transnasopharyngeal needle aspiration in the diagnosis of submucosal recurrence of nasopharyngeal carcinoma after chemoradiotherapy.

BACKGROUND: Recurrence of nasopharyngeal carcinoma (NPC) after chemoradiotherapy is common, but submucosal recurrence of NPC is rare. The final pathological results determine the optimal therapeutic schedule for treatment of NPC recurrence, but tissue retrieval from submucosal lesions is usually difficult. The present study aimed to assess the safety and efficacy of a novel approach of endonasopharyngeal ultrasound-guided transnasopharyngeal needle aspiration (ENUS-TNNA) for submucosal neoplasms in patients with suspected NPC recurrence. METHODS: Between March 2017 and June 2021, 11 post-chemoradiotherapy patients with suspected magnetic resonance imaging (MRI) findings of submucosal recurrence of NPC underwent ENUS-TNNA. The safety and effectiveness of using ENUS-TNNA to sample submucosal neoplasms were evaluated. RESULTS: Needle aspiration biopsies were performed without any incidences in all cases. Out of the 11 patients, nine were diagnosed with submucosal recurrence of NPC via histopathological or cytological evaluations. Of the two puncture-negative cases, one patient had atypical imaging findings and clinical manifestations and was therefore followed-up using MRI. After follow-up for 3 years, this patient was still considered to be cancer-free due to the shrinking diameters of the submucosal lesions. For the other puncture-negative patient, submucosal biopsy samples were obtained using a surgical method. Pathological examination of these biopsies revealed that an angiosarcoma had developed after radiotherapy. There were no severe complications that occurred during the ENUS-TNNA procedure. CONCLUSION: ENUS-TNNA is a safe, effective, and minimally invasive approach to obtain tissue samples from the submucosal region of the nasopharynx for patients with suspected NPC recurrence.

Clinical application of endonasopharyngeal ultrasound-guided transnasopharyngeal needle aspiration in the diagnosis of submucosal nasopharyngeal carcinoma.

BACKGROUND AND OBJECTIVES: Submucosal nasopharyngeal carcinoma (NPC) is a rare type, which is usually difficult to obtain tissue samples. We aimed to evaluate the diagnostic yield and safety of a new technique of endonasopharyngeal ultrasound-guided transnasopharyngeal needle aspiration (ENUS-TNNA) for submucosal NPC. SUBJECTS AND METHODS: This was a retrospective study. Between March 2018 and September 2019, 11 patients with submucosal nasopharyngeal neoplasms detected with previously computed tomography or magnetic resonance imaging underwent ENUS-TNNA. All patients had cytological evaluation by smears and tissue evaluation of aspiration specimens. Mean and rate. RESULTS: There were seven males and four females, with ages ranging from 33 to 77 years. Needle puncture biopsies were successfully performed in all cases, and sufficient tissue sample for histopathological examination was obtained from each of the 11 patients. Of the 11 patients, nine of these patients were diagnosed using ENUS-TNNA without on-site cytology assistance, false negative in two cases. The sensitivity of the ENUS-TNNA technique in diagnosing submucosal NPC was 81.82%. In the absence of any major complications, the procedure was uneventful. CONCLUSIONS: ENUS-TNNA is a safe and effective method to provide a pathological diagnosis of submucosal growth type of nasopharyngeal neoplasms, which has a great clinical value.

A Rare Presentation of Melanoma as a Retroperitoneal Mass Seen on FDG PET.

A 55-year-old woman presented with intermittent fatigue and abdominal pain. Ultrasound and CT scan showed a large heterogeneous mass in the retroperitoneum, suggestive of malignancy. F-FDG PET/CT was performed for staging. PET/CT images showed a hypermetabolic retroperitoneal mass. Endoscopy revealed a mass infiltrating the duodenum. Eventually, the mass was pathologically proved to be malignant melanoma. Further extensive clinical, radiological, and endoscopic investigations proved the retroperitoneum to be the primary site.

Adsorption and diffusion of hydrogen and oxygen in FCC-Co: a first-principles study.

Hydrogen and oxygen play an important role in the hydrogen embrittlement and oxidation of novel Co-based alloys with γ/γ' microstructure. In this study, the adsorption of hydrogen and oxygen atoms on the FCC-Co(111) surface and their diffusion behavior from the surface into the sub-layers and bulk have been investigated by means of first-principles calculations. It is observed that hydrogen and oxygen atoms prefer to adsorb on the fcc and hcp (threefold hollow) sites, respectively. The hydrogen atom can penetrate into the first and second sub-layers energetically, while it is not feasible for the oxygen atom as diffusion from the surface into the first sub-layer is more difficult. It is found that the calculated diffusion coefficients of hydrogen are in good agreement with the available experimental data. Finally, we briefly discuss the changes in total magnetic moment along the Oct-Tet-Oct diffusion path and the associated electronic structures. The present work is helpful to provide comprehensive guidance for the development and applications of novel Co-based alloys.

Docetaxel-based therapy with and without antiangiogenic agents as first-line chemotherapy for castration-resistant prostate cancer: A meta-analysis of nine randomized controlled trials.

The aim of this study was to systematically assess the effectiveness and safety of the addition of antiangiogenic agents to docetaxel-based chemotherapy for the treatment of castration-resistant prostate cancer. Computerized electronic databases, including Embase, PubMed and The Cochrane Library were searched for randomized controlled trials (RCTs) on the comparison between docetaxel-based therapy with and without antiangiogenic agents for the treatment of prostate cancer. The search time limit was from the building of the database until July 18, 2013. Following extracting information and conducting a methodological quality evaluation for study inclusion based on inclusion and exclusion criteria, RevMan 5.2 and Stata 12.0 software were used to perform a meta-analysis and the Jadad scale was used for evaluation of study quality. A total of 9 RCTs and 4,681 patients were included in this meta-analysis. The comparison between docetaxel-based therapy with and without antiangiogenic agents revealed no statistically significant differences regarding prostate-specific antigen response rate [risk ratio (RR)=0.99, 95% confidence interval (CI): 0.87-1.12, P=0.84], overall survival (OS) [hazard ratio (HR)=0.97, 95%CI: 0.91-1.05)] and progression-free survival (PFS) (HR=0.99, 95%CI: 0.83-1.18); however, the incidence of treatment-related mortality was higher in the docetaxel-based therapy with antiangiogenic agents group (RR=1.95, 95%CI: 1.23-3.11, P=0.005), whereas the incidence of thrombus formation was higher in the docetaxel-based therapy without antiangiogenic agents group (RR=0.57, 95%CI: 0.41-0.80, P=0.001). In conclusion, our findings indicated that docetaxel combined with antiangiogenic agents did not increase the OS or the PFS of the patients with castration-resistant prostate cancer, whereas it may increase the risk of treatment-related mortality. However, further RCTs with larger, high-quality patient samples are required to verify these findings.