Methylene Blue versus Coil-Based Computed Tomography-Guided Localization of Lung Nodules.

BACKGROUND: Preoperative computed tomography (CT)-guided localization has been shown to significantly improve lung nodule video-assisted thoracoscopic surgery (VATS)-based wedge resection technical success rates. However, at present, there was insufficient research regarding the optimal approaches to localization of these nodules prior to resection. We aimed to compare the relative clinical efficacy of preoperative CT-guided methylene blue and coil-based lung nodule localization. METHODS: In total, 91 patients with lung nodules were subjected to either CT-guided methylene blue (n = 34) or coil (n = 57) localization and VATS resection from January 2014 to December 2018. We compared baseline data, localization-associated complication rates, as well as the technical success of localization and resection between these two groups of patients. RESULTS: In total, 42 lung nodules in 34 patients underwent methylene blue localization, with associated localization and wedge resection technical success rates of 97.6 and 97.6%, respectively. A total of 71 lung nodules in 57 patients underwent coil localization, with associated localization and wedge resection technical success rates of 94.4 and 97.2%, respectively. There were no significant differences in technical success rates of localization or wedge resection between these groups (p = 0.416 and 1.000, respectively). The coil group sustained a longer duration between localization and VATS relative to the methylene blue group (13.2 vs. 2.5 hours, p = 0.003). CONCLUSION: Both methylene blue and coil localization can be safely and effectively implemented for conducting the diagnostic wedge resection of lung nodules. The coil-based approach is compatible with a longer period of time between localization and VATS procedures.

Diagnosis and Treatment of 26 Cases of Abdominal Cocoon.

BACKGROUND AND AIMS: Abdominal cocoon (AC) is a rare abdominal disease with nonspecific clinical features, and it is difficult to be diagnosed before operation and hard to be treated in clinical practice. The aim of this study is to investigate the diagnosis and treatment of AC. METHODS: The clinical manifestations, findings during surgery, treatments, and follow-up results of 26 cases of AC were retrospectively studied from January 2001 to January 2015. RESULTS: All of 26 cases were diagnosed as AC definitely by laparotomy or laparoscopic surgery. Their clinical findings were various, with 7 intestines obstructed with bezoars and 4 intestines perforated by spiny material. Based on the existence of the second enterocoelia, all cases were categorized into 2 types: type I is absent of second enterocoelia (18 cases, 69.23%), while type II shows second enterocoelia (8 cases, 30.77%). Twenty cases (12 were type I and 8 were type II) underwent membrane excision and careful enterodialysis to release the small intestine entirely or partially, while the other 6 cases (all were type I) did not. In addition, all patients were treated with medical treatment and healthy diet and lifestyle. Finally, most of the patients recovered smoothly. CONCLUSIONS: AC can be categorized into two types; surgery is recommended for type II and part of type I with severe complications, but sometimes conservative therapy might be appropriate for type I. Laparoscopic surgery plays an important role in the diagnosis and treatment of AC. Furthermore, favorite health education, healthy diet and lifestyle are of significance in patients' recovery.

[The effects of NOX4 and TGF-ßinvolved in airway remodeling of Chronic Obstructive Pulmonary Disease].

OBJECTIVE: To investigate the role of nicotinamide adenine dinucleotide phosphate 4 (NADPH4,NOX4) and transforming growth factor-beta (TGF-ß) involve in pathogenesis of airway remodeling in chronic obstructive pulmonary disease (COPD). METHODS: Lung tissues from 36 COPD patients and 19 patients with normal lung function were enrolled in this study. The volume of airway smooth muscle (ASM)mass was evaluated. The expressions of NOX4, collagen Ⅳ (Col Ⅳ) and TGF-ß were tested by a semi-quantitative morphological and/or immunohistochemistry staining method and Western blot, and their correlations with pulmonary functions were analyzed. RESULTS: ①Index of the percentage of the thickness of ASM/external diameter of small airway (WT%) and the percentage of the area of ASM/transverse area of small airway (WA%) were significantly higher in the COPD group than those in controls(P<0.05).②In COPD patients,epithelial cells metaplasia were found and α-SMA and Col Ⅳwere expressed in a part of epithelial cells. The expressions of α-small muscle actin (α-SMA) and Col Ⅰ were increased in COPD patients in comparison with the patients without obstructive airway disorders(P<0.05).③The expression of NOX4 in ASM and epithelial cells of COPD patients was significantly higher in comparison with the patients without COPD. The expression of NOX4 in ASM of small airway were statistically different among different COPD grade (P<0.05). Correlation analysis demonstrated that the level of NOX4 protein in ASM of small airway was inversely associated with pulmonary functions. ④The expression of TGF-ß in COPD was significantly higher than that in patients without COPD. ⑤ Correlation analysis demonstrated that the level of NOX4 protein in ASM of small airway, WT% and WA% were inversely associated with pulmonary functions. CONCLUSIONS: ①The airway remodeling of COPD is characterized by increasing hyperplasia of small airway smooth muscle.②Remodeling of airway smooth muscle associats with severity of airflow limitation in COPD patients. ③The expressions of NOX4, TGF-ß and α-SMA in COPD epithelial cells and small airway smooth muscle cells are significantly enhanced. The expressions of NOX4, α-SMA and TGF-ß are positively correlated with the severity of chronic obstructive pulmonary air flow, suggesting that TGF-ß and NOX4 signaling may be involved in the development of chronic obstructive pulmonary disease airway remodeling.

[Construction and identification of human p-selectin promotor luciferase reporter gene vector].

OBJECTIVE: To construct a luciferase reporter gene vector of p-selectin gene promoter and determine its transcriptional activity for screening the effect of drugs on the transcriptional activity of p-selectin promoter. METHODS: Primers were designed based on human p-selectin promoter sequence from UCSC software. The p-selectin promoter from human genome DNA was then amplified. After digestion of pGL3-Basic vector and p-selectin promoter with Kpn I and Xho I, p-selectin promoter was inserted into pGL3-basic vector. The recombinant plasmid, namely pGL3-p-selectin-promoter, was transiently cotransfected into 293F cells with pRL-SV40 as the control vector, and the activity of the dual luciferase was detected. The transcription activity of serially truncated segments of the p-selectin promoter reporter gene was quantified by luciferase expression. 293F cells transfected with pGL3-p-selectin-promoter reporter gene and dual luciferase were stimulated with LPS, TNF-α and As2O3, and the transcriptional activity of p-selectin promoter were assessed. RESULTS: pGL3-p-selectin-promoter was constructed successfully as verified by restriction digestion and sequence analysis. The luciferase activity was higher in pGL3-p-selectin-promoter/pRL-SV40 group than in pGL3-basic/pRL-SV40 group (0.8573±0.4703 vs 0.03955±0.05894). pGL3- 1826 bp was actively transcribed compared with pGL3-1092 bp and pGL3-3738 bp. LPS, TNF-α and As2O3 significantly enhanced the transcriptional activity of p-selectin promoter. CONCLUSION: pGL3-p-selectin-promoter can be transcribed and activated in 293F cells. This study provided an important basis for acquiring transcriptional factors and screening inflammatory factors and drugs.