Validation of a modified Caprini risk assessment model in lung cancer patients undergoing surgery: Results of a multicenter cross-sectional observational study.

BACKGROUND AND OBJECTIVES: Lung cancer patients slated for surgery are at high risk of venous thromboembolism (VTE). Precise risk assessment is necessary for providing proper thromboprophylaxis and reducing morbidity and mortality of VTE. METHODS: A multicenter, observational, cross-sectional cohort study, involving patients with primary lung cancer undergoing surgery, was carried out from August 2016 to December 2019. All patients were assessed according to the Caprini risk assessment model (RAM) and a modified scoring system incorporating elevated D-dimer and new stratification of surgical time. The endpoint was confirmed VTE or patient discharge. RESULTS: Out of 1205 patients, 87 (7.2%) were diagnosed with VTE. The area under the curve of modified scores for VTE was 0.759, which was larger than that of the original one (0.589) (p < 0.05). By modified Caprini scoring system, a higher score was associated with increased VTE risk (odds ratio [OR], 1.345; 95% confidence interval [CI], 1.197-1.512; p < 0.001), and there was an increased OR of 4.090 (95% CI, 2.472-6.768, p < 0.001) for VTE in high-risk category patients. CONCLUSION: Modified Caprini RAM showed an improved prediction of high-risk patients with an elevated likelihood of postoperative VTE compared to the original one.

Anxiety and depression and their interdependent influencing factors among medical students in Inner Mongolia: the cross-sectional survey.

BACKGROUND: Mental health has become a global problem, among which anxiety and depression disorder were ranked as the first and sixth leading causes of disability, respectively, according to the World Health Organization (WHO). Medical students experienced higher levels of anxiety and depression than the general population. But there was a lack of research on the emotional situation among medical students in Inner Mongolia. The main objectives of this study were to investigate the prevalence of anxiety and depression symptoms as well as the factors that influence them among medical students in Inner Mongolia. METHODS: A cross-sectional study was conducted on 1282 students from a university in Inner Mongolia, China, ranging in age from 16 to 27 years. They were assessed demographic indicators, the disorder of anxiety and depression using Zung's Self-Rating Anxiety Scale and Self-Rating Depression Scale (SAS and SDS) by an anonymous, self-administered questionnaire. The internal reliability and validity of the questionnaire were determined using Cronbach's alpha coefficient, Kaiser-Meyer-Olkin (KMO), and Bartlett's sphericity. T-tests and one-way ANOVA were used to explore factors, including demographic and behavioral information influencing anxiety and depression disorder. According to the above results of exploring the influencing factors based on univariate analysis, significant factors (p < 0.05) were entered into multiple linear regressions that sequentially fitted to predictors associated with anxiety and depression. The collected data were entered into EpiData for windows and analyzed using SPSS 26.0. The p < 0.05 was considered to be significantly different. RESULTS: The questionnaire was completed by 1187 students with a 92.59% response rate. The prevalence of anxiety and depression symptoms among medical students were 10.36% and 24.43%, and the mean ± standard deviation (M ± SD) anxiety and depression scores were 39.60 ± 7.81 and 48.23 ± 9.06, respectively, among the medical students. The specific contributions of the two scales with good reliability and validity were 60.58% and 63.59%, respectively. For univariate analysis, age, whether the daily meal was at a fixed time, grade, the birthplace of students, average daily eating habits, were the factors that influenced both the total score of SAS and SDS (p < 0.05). For further analysis, the results showed that "Birthplace of students" and "Whether daily meals at a fixed time" were significantly associated with anxiety and depression. Furthermore, "Age" and "Mode of delivery" were independent risk factors for depressive disorder. CONCLUSION: Our findings revealed that high prevalence of mental health problems among medical students in Inner Mongolia. The Ministry of Medical Education should make a targeted intervention for specific risk factors of this study to improve psychological well-being and face uncertain future challenges among university students in Inner Mongolia.

NUT CONSUMPTION IS ASSOCIATED WITH DEPRESSIVE SYMPTOMS AMONG CHINESE ADULTS.

BACKGROUND: Affective disorders, especially depressive symptoms, bring such a burden to mortality and morbidity that they are associated with physical and psychological health and quality of life. Nuts, a foodstuff rich in multiple micronutrients, macronutrients, and other useful components, were considered to be a protector against depressive symptoms. Here, we conducted an analysis to examine the relationship between nut consumption and depressive symptoms. METHODS: The study performed a cross-sectional study to examine whether nut consumption is related to depressive symptoms among 13,626 inhabitants in Tianjin. Nut consumption was assessed using a validated food frequency questionnaire and depressive symptoms was assessed using the Chinese version of 20-item Self-rating Depression Scale (SDS) with four cutoffs (40, 45, 48, and 50) to indicate elevated depressive symptoms. RESULTS: The prevalence of depressive symptoms was 38.7, 19.1, 11.4, and 7.3% for SDS ≥40, 45, 48, and 50, respectively. After adjustments for potential confounding factors, the odds ratios (95% confidence interval) of having elevated depressive symptoms with SDS ≥40 by increasing frequency of nut consumption were 1.00 for

Complete resection of a giant mediastinal teratoma occupying the entire right hemithorax in a 14-year-old boy.

BACKGROUND: Mature teratomas are the most common histological type of germ cell tumors. CASE PRESENTATION: A 14-year-old boy was referred to our hospital with a giant mature teratoma occupying the entire right hemithorax compressed the superior vena cava (SVC) and total atelectasis of the right lung. He was misdiagnosed as malignant teratoma by a fine-needle biopsy in a hospital. After 4-cycle of chemotherapy without effect, he underwent an unsuccessful exploratory thoracotomy. Venous conduit bypass between the right jugular vein and right femoral vein was established in the operating room for superior vena cava (SVC) replacement if needed. En bloc resection of the huge tumor, wedge resection of the dense adhesions of the right lung and partial pericardectomy were successfully performed, and lung function was recovered. CONCLUSION: To the best of our knowledge, this is the first report of complete resection of the teratoma occupying the whole right hemithorax combined with wedge resection of the right upper, middle and lower lobes and partial resection of the pericardium.

[Analysis of the Incidence of Lower Limb Deep Venous Thrombosis 
and Its Related Risk Factors in the Postoperative Patients with Lung Cancer].

BACKGROUND: Lung cancer is the first leading cause of morbidity and mortality among the malignant tumors, which has become a hot issue in current research. Clinically, lung cancer is divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) according to the pathological types. NSCLC includes adenocarcinoma, squamous cell carcinoma and other types of lung cancer, accounting for about 80% of all lung cancer. Venous thromboembolism (VTE) includes deep venous thrombosis (DVT) and pulmonary embolism (PE), which is a recognized complication in lung cancer patients with higher morbidity and mortality. The aim of this study is to determine the incidence of DVT and reveal the risk factors for DVT in the postoperative patients with lung cancer. METHODS: We collected 83 postoperative patients with lung cancer admitted to the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital from December 2021 to December 2022. All these patients were examined by color Doppler ultrasound of lower extremity vein upon admission and after operation to analyze the incidence of DVT. In order to explore the possible risk factors for DVT in these patients, we further analyzed the correlations between DVT and their clinical features. At the same time, the changes of coagulation function and platelet were monitored to investigate the value of blood coagulation in the patients with DVT. RESULTS: DVT occurred in 25 patients after lung cancer operation, and the incidence rate of DVT was 30.1%. Further analysis found that the incidences of postoperative lower limb DVT were higher in lung cancer patients of stage III+IV or over 60 years of age (P=0.031, P=0.028). D-Dimer level in patients with thrombosis was significantly higher than that in non-thrombus patients on the 1st, the 3rd, and the 5th day after operation (P<0.05), and there was no significant difference in platelets and fibrinogen (FIB) (P>0.05). CONCLUSIONS: The overall incidence of DVT in our center after lung cancer patients operation was 30.1%. Late-stage and older postpatients were more likely to develop DVT, and these patients with higher D-Dimer values should be considered the possibility of VTE events.

Prevalence of overweight/obesity and related factors in Keerqin District, Tongliao City: A cross-sectional study.

OBJECTIVE: This study aimed to analyze the prevalence of overweight/obesity and the factors influencing these conditions among 9- to 18-year-old adolescents in Keerqin District of Tongliao City. We explored whether overweight/obesity is accompanied by differences in eating habits, lifestyle, and mental health. METHODS: A cross-sectional survey was administered to 1,736 adolescents in November 2020. A physical examination was performed for each participant, and an online questionnaire was adopted to collect information. The association of several risk factors with overweight/obesity was explored using a logistic regression model. RESULTS: The prevalence of overweight/obesity in the study population was 43.32%. The risk of overweight/obesity was higher among nonresident students (odds ratio [OR] = 1.564, 95% CI = 1.182-2.069) who had an average of 3-4 (OR = 2.164, 95% CI = 1.087-4.308) or 5 or more (OR = 2.114, 95% CI = 1.376-3.248) PE classes per week. The risk of overweight/obesity was lower among girls (OR = 0.485, 95% CI = 0.396-0.593), students aged 15-16 years (OR = 0.288, 95% CI = 0.135-0.617) and those aged 17-18 years (OR = 0.282, 95% CI = 0.124-0.639), students who ate sweets more than once a week (OR = 0.570, 95% CI = 0.366-0.887), students who spent less than 1 hour per day on the computer each week (OR = 0.776, 95% CI = 0.620-0.971), students with depressive symptoms (Center for Epidemiologic Studies Depression Scale [CES-D] score ≥ 16) (Model 2: OR = 0.618, 95% CI = 0.385-0.990; Model 3: OR = 0.623, 95% CI = 0.388-1.000), and students with depressed affect (Model 2: OR = 0.921, 95% CI = 0.877-0.967; Model 3: OR = 0.929, 95% CI = 0.885-0.976). CONCLUSION: Overweight/obesity was influenced by eating habits and lifestyle factors. In addition, overweight/obesity adolescents had a lower risk of depressed than those with normal weight.

miR-27a-3p alleviates lung transplantation-induced bronchiolitis obliterans syndrome (BOS) via suppressing Smad-mediated myofibroblast differentiation and TLR4-induced dendritic cells maturation.

BACKGROUND: Bronchiolitis obliterans syndrome (BOS), induced by a chronic rejection, remains a significant obstacle for end-stage lung diseases after lung transplantation. We have previously determined that the small non-coding mRNA (miRNA) miR-27a-3p maintained the immature state of dendritic cells (DCs) via the interleukin 10 (IL-10)-dependent regulatory pathway. Such status helped in preventing rejection and alleviating BOS. The present study explored mechanisms how miR-27a-3p may suppress the fibrosis as well as the maturation of DCs, ultimately attenuating BOS in vitro and in vivo. METHODS/RESULTS: In our tracheal transplantation mouse model, the expression of Smad2, Smad4, and αSMA were significantly decreased in the miR-27a-3p-transfected DCs (p < 0.0001, p = 0.0006, and p = 0.0002 respectively). Moreover, the expression of fibrosis markers (α-SMA, collagen I, and Fn) were potently inhibited in the miR-27a-3p-transfected NIH-3 T3 cells (p < 0.0001, p = 0.00148, and p < 0.0001 respectively). At the same time, reversed results were observed in the inhibitor group (p = 0.0002, p < 0.0001, and p < 0.0001 respectively), indicating that miR-27a-3p could directly inhibit myofibroblast differentiation. Furthermore, in the tracheal transplanted mice, the population of Treg cells was significantly decreased (p < 0.0001). In contrast, Th17 cells were down-regulated in the miR-27a-3p-transfected DCs group (p < 0.0001), accompanied by the decreased IL-17 levels (p = 0.0007) and the induction of TGF-ß1 and IL-10 (p < 0.0001 and p = 0.0016 respectively). Further mechanistic studies indicated that miR-27a-3p altered the maturation of DCs by targeting TLR4 and IRAK (p < 0.0001 and p = 0.0002 respectively). CONCLUSIONS: Our study suggests that miR-27a-3p selectively blocked the TGF-ß1/Smad pathways to suppress the myofibroblast differentiation and targeted the TRL4/IRAK4 pathway to restrain DCs maturation, thus attenuating BOS. Our findings suggest that miR-27a-3p is a potential active molecule on BOS management after lung transplantation.

CircSMARCA5 silencing impairs cell proliferation and invasion via the miR-17-3p-EGFR signaling in lung adenocarcinoma.

AIMS: Circular RNAs are widely expressed in various cancers and play important roles in tumorigenesis and tumor progression. The function and mechanism of circSMARCA5 in lung adenocarcinoma however remains unclear. MAIN METHODS: QRT-PCR analysis was applied for determining circSMARCA5 expression in lung adenocarcinoma patient tumor tissues and cells. Molecular biological assays were used for investigating the role of circSMARCA5 in lung adenocarcinoma progression. Luciferase reporter and bioinformatics assays were used for identifying the underlying mechanism. KEY FINDINGS: In this study, we observed that circSMARCA5 expression was decreased in lung adenocarcinoma tissues but silencing of circSMARCA5 in lung adenocarcinoma cells inhibited cell proliferation, colony formation, migration and invasion. Mechanistically, we found EGFR, c-MYC and p21 were down-regulated upon circSMARCA5 knockdown. MiR-17-3p efficiently down- regulated EGFR expression via directly binding to EGFR mRNA. SIGNIFICANCE: These studies suggest that circSMARCA5 functions as an oncogene via targeting miR-17-3p-EGFR axis and may represent a promising therapeutic target for lung adenocarcinoma.

Apatinib added when NSCLC patients get slow progression with EGFR-TKI: A prospective, single-arm study.

BACKGROUND: Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) acquired resistance was an inevitably events in NSCLC treatment. AIMS: Intending to overcome the acquired resistance of EGFR-TKI. MATERIALS & METHODS: A clinical trial was, we enrolled 12 patients who were slowly progressing on first-generation EGFR-TKI, and added apatinib when the patients got slow progression. RESULTS: Seven patients were included in the efficacy analysis. The median PFS2 of apatinib combined with EGFR-TKI was 8.2 months (95% CI, 7.3 m-NA), and the total PFS reached 20.9 months (95% CI, 17.3 m-NA) when plus PFS1. All the adverse events were manageable. The median PFS was significantly longer for circulating tumor DNA (ctDNA)-cleared patients (8.4 months; 95% CI, 8.2-NA) than for those ctDNA not cleared (7.1 months; 95% CI, 6.9-NA) (p = 0.0082). DISCUSSION: The addition of apatinib did improve the duration of first-generation EGFR-TKI use, and the duration was better than the first-line use of third-generation EGFR-TKI. CONCLUSION: The addition of apatinib when the patients got slow progression after initial EGFR-TKI therapy may be a good treatment option and the side effects are controllable. It is possible to monitor treatment efficacy using ctDNA.

[Preliminary Recommendations on the Timing of Lung Surgery after 
Novel Coronavirus Infection in Patients with Pulmonary Nodules and Lung Cancer].

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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Effects of BTG2 on proliferation inhibition and anti-invasion in human lung cancer cells.

The objective of the study was to investigate the impact of the B cell translocation gene 2 (BTG2) on lung cancer cell growth, proliferation, metastasis, and other biological characteristics and to provide experimental evidence for the biological treatment of human lung cancer. A pcDNA3.1-BTG2 eukaryotic expression vector was constructed and transfected into the human lung cancer cell line A549. The biological changes in the BTG2-expressing cells were analyzed using growth curves, the MTT (tetrazolium) assay, propidium iodide (PI) staining, and the Transwell invasion chamber. Additionally, Western blotting was used to determine the impact of BTG2 on the protein expression of cyclin D1, MMP-1, and MMP-2. Compared to the empty vector-transfected A549 cells or the mock-transfected A549 cells, the pcDNA3.1-BTG2-transfected A549 cells grew significantly slower. No significant differences were detected between the empty vector-transfected group and the mock-transfected A549 cells. The growth curve analysis and the PI staining showed that the pcDNA3.1-BTG2-transfected cells grew significantly slower than the empty vector-transfected A549 cells (P < 0.05). The cell invasion assay results suggested that the invasion rate of the pcDNA3.1-BTG2-transfected A549 cells was significantly slower than the invasion rate of the empty vector-transfected group and the mock-transfected group (P < 0.05). The overexpression of BTG2 may inhibit the protein expression of cyclin D1, MMP-1, and MMP-2 in A549 cells. The overexpression of BTG2 may inhibit the growth, proliferation, and invasiveness of the A549 human lung cancer cell line.

Primary lung lymphoma involving the superior vena cava.

Primary lung lymphoma (PLL) presenting as a primary pulmonary lesion is rare and usually affects elderly people. Here we describe a 25-year-old Chinese man diagnosed with primary lung lymphoma, which presented as a huge lung tumor mimicking a primary lung cancer and involving the superior vena cava. He underwent double-sleeve reconstructions of bronchus and pulmonary arteries with right upper- and middle-lobe lobectomy along with replacement of the superior vena cava with a graft, and was then given standard chemotherapy of CHOP plus Rituximab. The patient has been well, showing no local recurrence or distal metastasis during a 27-month follow-up.

A modular spectrum sensing system based on PSO-SVM.

In the cognitive radio system, spectrum sensing for detecting the presence of primary users in a licensed spectrum is a fundamental problem. Energy detection is the most popular spectrum sensing scheme used to differentiate the case where the primary user’s signal is present from the case where there is only noise. In fact, the nature of spectrum sensing can be taken as a binary classification problem, and energy detection is a linear classifier. If the signal-to-noise ratio (SNR) of the received signal is low, and the number of received signal samples for sensing is small, the binary classification problem is linearly inseparable. In this situation the performance of energy detection will decrease seriously. In this paper, a novel approach for obtaining a nonlinear threshold based on support vector machine with particle swarm optimization (PSO-SVM) to replace the linear threshold used in traditional energy detection is proposed. Simulations demonstrate that the performance of the proposed algorithm is much better than that of traditional energy detection.

Survival Benefits for Pulmonary Adenocarcinoma With Malignant Pleural Effusion After Thoracoscopic Surgical Treatment: A Real-World Study.

Objectives: Malignant cells in the pleural fluid or pleural metastasis are classified as stage IV non-small cell lung cancer. Radical surgery is generally considered not suitable for such patients. The aim of our study was to discuss the effectiveness of video-assisted thoracoscopic surgery (VATS) in such patients. Methods: A retrospective analysis of the clinical records of 195 patients was performed. These patients were all diagnosed with locally advanced pulmonary adenocarcinomas with malignant pleural effusion (MPE, M1a) but no distant organ metastasis. The 195 patients included 96 patients who underwent VATS plus chemotherapy and 99 patients who received thoracic drainage plus chemotherapy. The baseline characteristics of the patients included age, gender, smoking history, Eastern Cooperative Oncology Group (ECOG) score, and number of chemotherapy cycles (2-4 cycles or >4 cycles); we also analyzed clinical characteristics including the specific surgical options of the VATS group. Results: In multivariate analysis, when compared to the thoracic drainage group, the VATS group remained significantly associated with the overall survival [HR=0.480 (95%CI 0.301-0.765)]; when compared to the lobectomy, the sub-lobectomy and the palliative surgery, remained significantly associated with the overall survival [HR=0.637 (95%CI 0.409-0.993) and HR=0.548 (95%CI 0.435-0.832), respectively]. The median survival time (MST) of patients who underwent VATS (n = 96, 49.2%) was 25 months (95% CI 22.373-27.627) whereas the patients who received thoracic drainage (n = 99, 50.8%) was 11 months (95% CI 9.978-12.022). For patients who underwent VATS, the MST of patients who received a lobectomy (n = 50, 52.1%) was 27 months (95% CI 22.432-31.568), the MST of patients who received a sub-lobectomy plus pleurodesis (n = 26, 27.1%) was 27 months (95% CI 19.157-34.843), and the MST of patients who received only pleurodesis (n = 20, 20.8%) was 12 months (95% CI 7.617-16.383). Conclusion: For pulmonary adenocarcinomas with MPE, receiving a lobectomy or sub-lobectomy plus pleurodesis with VATS was associated with improved survival compared with patients who only received thoracic drainage and chemotherapy. Our results and previously published data may justify the use of VATS for treating pulmonary adenocarcinomas with MPE.

Effectiveness and Safety of Probiotics for Patients with Constipation-Predominant Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis of 10 Randomized Controlled Trials.

To perform a systematic review and meta-analysis to evaluate the effectiveness and safety of probiotics in the treatment of constipation-predominant irritable bowel syndrome (IBS-C), we searched for randomized controlled trials (RCTs) comparing probiotic care versus placebos for patients with IBS-C in five comprehensive databases (March 2022). The risk of bias was assessed using the Cochrane Collaboration Risk of Bias Tool. RevMan 5.3 was used to perform a meta-analysis on stool consistency, abdominal pain, bloating, quality of life (QoL), fecal Bifidobacterium and Lactobacillus counts, and adverse events. The GRADE approach was used to evaluate the certainty of the evidence. Ten RCTs involving 757 patients were included. Only three studies were rated as having a low risk of bias. The meta-analysis results show that, compared to the placebo, probiotics significantly improved stool consistency (MD = 0.72, 95% CI (0.18, 1.26), p < 0.05, low quality) and increased the number of fecal Bifidobacteria (MD = 1.75, 95% CI (1.51, 2.00), p < 0.05, low quality) and Lactobacillus (MD = 1.69, 95% CI (1.48, 1.89), p < 0.05, low quality), while no significant differences were found in abdominal pain scores, bloating scores, QoL scores, or the incidence of adverse events (p > 0.05). The low-to-very low certainty evidence suggests that probiotics might improve the stool consistency of patients with IBS-C and increase the number of Bifidobacteria and Lactobacilli in feces with good safety. However, more high-quality studies with large samples are needed to verify the findings.

Neoadjuvant camrelizumab and chemotherapy in patients with resectable stage IIIA squamous non-small-cell lung cancer: Clinical experience of three cases.

Neoadjuvant immunochemotherapy has attracted much attention as a treatment for locally advanced non-small-cell lung cancer. However, there is scarce evidence of the safety and efficacy of camrelizumab as neoadjuvant in lung cancer. Here, we present three patients who were diagnosed with IIIA squamous non-small-cell lung cancer from September to December in 2020 and received two cycles of neoadjuvant camrelizumab plus nab-paclitaxel and nedaplatin, followed by surgical resection. All three patients had a reduction in the tumor size on CT image and not delayed planned surgery. We did not observe grade 3 or 4 adverse events. Two of the three patients achieved a major pathological response (MPR), including one complete tumor regression of the primary lung tumor. Multiplex fluorescent immunohistochemistry revealed that CD8+ T cells, FoxP3+ regulatory T cells, and PD-L1 expression on immune cells in the surgical specimen were much higher than in the pretreatment biopsy sample in patients with MPR. This was not observed in the patient without MPR. Camrelizumab plus chemotherapy could potentially be a neoadjuvant regimen for resectable IIIA squamous non-small-cell lung cancer, with a high MPR proportion, and did not compromise surgical procedure. Our findings should be validated in a future randomized clinical trial.

Prehypertension and insulin resistance among Mongolian people, Inner Mongolia, China.

BACKGROUND: There is little knowledge on association of prehypertension with insulin resistance among Mongolian people. The purpose of the present study is to explore whether there are phenomena of insulin resistance in the phase of prehypertension in the Mongolian population. METHODS: 2553 Mongolian people were included in the present analysis. Data on demographic characteristics, lifestyle risk factors, family history of hypertension and medical history were obtained, blood pressure, body weight, height and waist circumference measured, fasting blood samples collected and blood lipids, fast plasma glucose and insulin determined for all individuals. RESULTS: Among participants who are overweight, the means of the homeostatic model assessment of insulin resistance (HOMA-IR) were significantly higher in prehypertensives than those in normotensives. Prehypertension was significantly associated with the higher levels of HOMA-IR after multivariate adjustment. Compared with HOMA-IRs < 1.64, multivariate-adjusted ORs (95% CI) for HOMA-IRs of 1.64-2.32, 2.33-2.84, 2.85-3.76 and ≥3.76 were 1.056 (0.786-1.418), 1.565 (1.158-2.116), 1.381 (1.020-1.870) and 1.435 (1.046-1.970), respectively. CONCLUSIONS: Prehypertension was significantly associated with insulin resistance in the Mongolian population, and this study suggest that insulin resistance may play an important role in development of hypertension.

Mucinous adenocarcinoma caused by cancerization from a ciliated multinodular papilloma tumor: A case report.

Ciliated multinodular papilloma tumor (CMPT), a subtype of proximal bronchiolar adenoma (BA), is a rare mucin-producing papillary tumor arising in the peripheral lung. The nature of CMPT is so far controversial. The hypothesis that CMPT is a precancerous lesion that can lead to mucinous adenocarcinoma requires further research. A 61-year-old man with a ground-glass opacity (GGO) suspected to be lung adenocarcinoma in the right lower lobe of his lung underwent surgical treatment. Postoperative pathology suggested that the patient had mucinous adenocarcinoma caused by cancerization from CMPT. Targeted next-generation sequencing (NGS) was utilized to detect driver mutations in tumor DNA. Among the identified mutated genes, there were regrettably no high frequency mutations. This report describes a case of mucinous adenocarcinoma caused by cancerization from CMPT, indicating that CMPT may be a neoplasm rather than a metaplastic process and provides histological evidence for the hypothesis that CMPT is a precancerous lesion of mucinous adenocarcinoma.

The analysis of surgical prognostic factors and molecular typing of locally advanced lung squamous cell carcinomas.

Lung squamous cell carcinoma (LSCC) is a common subtype of non-small cell lung cancer (NSCLC), accounts for about 30% of all lung cancer, and has unique clinical and histologic characteristics. The predominant treatment of LSCC is surgical intervention. The purpose of this study was to explore the survival rates of the patients with primary LSCC after surgical treatment and the factors affecting prognosis. And also to analyze the molecular typing of local advanced LSCC of patients with various survival periods. We retrospectively evaluated the files of 170 patients with squamous NSCLC who were treated at the Department of Lung Cancer Surgery, Tianjin Medical University General Hospital, between January 2008 and December 2011. Univariate (Cox regression analysis) and multivariate (likelihood ratio) analyses were carried out for overall survival (OS) and the median survival duration. A P-value of < .05 was defined as significant. And then, we detected the mutation of 56 genes related to lung cancer by next-generation sequencing for two groups of lung squamous cell cancer patients, in which the OS was more than 3 years in one group and less than 1 year in the other group. In addition, we analysis the relationship between the molecular typing and the survival period. Next, we used the Cancer Genome Atlas (TCGA) database to compare the different patients' clinical information with the genes, which have been analyzed in our patients' tumor tissue samples.

Clinical mid-term outcomes of the Chinese-made CL-V bileaflet mechanical heart valve in Chinese patients.

BACKGROUND: The CL-V full-carbon bileaflet mechanical heart valve is a novel Chinese-made prosthetic valve. This study evaluated the mid-term outcomes of the CL-V bileaflet mechanical heart valve after implantation in Chinese patients. METHODS: This study retrospectively enrolled a total of 38 consecutive patients who underwent elective mechanical heart valve replacement (MHVR) with two different valve types from April 2004 and May 2010, including 18 patients with the CL-V bileaflet mechanical heart valve (44.4% male, mean age 47.4±6.2 years, mean body weight 64.7±11.9 kg) and 20 patients with the St. Jude mechanical heart valve (45.0% male, mean age 49.7±7.6 years, mean body weight 66.1±11.1 kg). All patients underwent follow-up clinical evaluations in the outpatient department at all-time points. RESULTS: No complications occurred during the mean 61.3 months follow-up time (range, 47-102 months). The cardiothoracic ratios (52.7%±4.5% vs. 50.1%±4.0%), left atrium diameter (46.5±7.6 vs. 44.8±9.3 mm), left ventricular diastolic diameter (47.6±4.9 vs. 48.2±8.5 mm) and left ventricular ejection fraction (65.4%±8.7% vs. 64.5%±8.0%) were not significantly different between the two groups (P>0.05). Transthoracic Doppler echocardiography showed that the hemodynamic indexes were not significantly different between the two groups at 1 year and 3 years (P>0.05). Furthermore, no significant differences were found between the two groups in hemocompatibility indexes at both 6 months and 3 years postoperatively (P>0.05). CONCLUSIONS: The mid-term follow-up results of the CL-V bileaflet mechanical heart valve were similar to those of the St. Jude Medical heart valve, which showed stable hemodynamics and good blood compatibility. Chinese-made CL-V bileaflet mechanical heart valves can be a substitute for St. Jude Medical heart valves, and can be widely used in cardiac surgery. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2000034158.