[Safety and effectiveness of interventional bronchoscopy under general anesthesia in the elderly patients with central airway stenosis: a retrospective study].

We retrospectively reviewed the clinical data of patients aged 65 years and older with central airway stenosis who underwent therapeutic bronchoscopy under general anesthesia in Beijing Tiantan Hospital from January 2012 to September 2022. A total of 167 patients were included in the study. One or more comorbidities were present in 151 patients. The number of operation procedure was 230 times. Laryngeal mask ventilation under general anesthesia and electrotomy was the most common method of airway management and operation. The incidence of major complications was 5.2%. One patient with granular cell tumor died of major bleeding during stent removal. The primary malignant lesion, number of comorbidities, electrolyte disturbances and rigid bronchoscopy were risk factors for major complications, and the difference was statistically significant. The overall response rate was 99.4%. The airway stenosis grade, dyspnea score and KPS value were improved, and the differences were statistically significant. Interventional bronchoscopy under general anesthesia appeared to be safe and effective in patients aged 65 years and older with central airway stenosis. Age should not be a contraindication to interventional bronchoscopy.

[Progress in research of long-term protective efficacy of human papillomavirus vaccine].

The efficacy of HPV vaccine in preventing cervical cancer has been demonstrated in numerous clinical trials and clinical uses. The follow-up after clinical trials usually last for 5-6 years to evaluate the long-term efficacy, and a series of long-term follow-up studies have been conducted in some regions. The literature retrieval of HPV vaccine long term efficiency research both at home and abroad indicated that the protective efficacy of the vaccine against vaccine-type-related cervical intraepithelial neoplasia grade 2 and above is higher than 90%.

Virtual touch imaging quantification shear-wave elastography for breast lesions: the diagnostic value of qualitative and quantitative features.

AIM: To investigate the value of the qualitative and quantitative features of Virtual Touch imaging quantification (VTIQ) shear-wave elastography in the characterisation of breast lesions. MATERIALS AND METHODS: Conventional ultrasound (US) and VTIQ were performed in 148 solid breast lesions in 148 women. During qualitative analysis, patterns of VTIQ were categorised into two patterns, 1 and 2. During quantitative analysis, the mean SWV (SWVmean) and the maximum SWV (SWVmax) of each lesion were used. The sensitivity, specificity, and the areas under the receiver operating characteristic (ROC) curve (Az value) were calculated for conventional US, VTIQ, and combined conventional US and VTIQ. RESULTS: Malignant lesions were more likely to show VTIQ pattern 2 than the benign lesions (p<0.001). There was no significant difference in the Az values between SWVmean (0.907) and SWVmax (0.902; p=0.572). There was no significant difference in the Az values between the VTIQ pattern (0.884) and SWVmax (p=0.572). The combined conventional US and VTIQ pattern carried a similar Az value (0.949) as compared with the combined conventional US and SWVmax, which yielded an Az value of 0.952 (p=0.683). CONCLUSION: The combination of either VTIQ pattern or SWVmax and conventional US may be helpful in the characterisation of benign and malignant breast lesions.

Interobserver variability between experienced radiologists in evaluating the number of abnormal lymph nodes seen on preoperative axillary ultrasound.

AIM: To determine the interobserver variability of experienced radiologists in evaluating the number of suspicious lymph nodes (LNs) seen on axillary ultrasound (AUS) examination, and to evaluate the effects of clinicopathological features on the discordance. MATERIAL AND METHODS: A prospective non-randomised triple-blind study was conducted from July 2016 to December 2017 at Shanghai Ruijin Hospital. Three experienced radiologists performed AUS on 462 patients (469 axillae) with invasive breast cancer independently and assessed the number of abnormal LNs during the real-time AUS examination. Interobserver agreement was determined according to the kappa statistic. RESULTS: The mean numbers of metastatic LNs on final histology study were 0.35, 0.98, 3.05 and 4.70 for patients with 0, 1, 2 and >2 abnormal nodes on preoperative AUS. When the cut-off (the number of abnormal LNs seen on AUS was >1) at which the maximal sum of sensitivity and specificity for diagnosis of ≥3 tumour-involved LNs was achieved was applied, the Az values ranged from 0.776 to 0.811. When the number of abnormal LNs was grouped into two-category classification (0-1 versus ≥2 abnormal LNs detected by AUS), good interobserver agreement (kappa: 0.601-0.687) was found, and disagreement between the radiologists was more frequently found in patients with T2-stage tumour and in those with one or two tumour-involved nodes. CONCLUSION: Abnormal LN count according to two-category classification (0-1 versus ≥2 abnormal LNs detected by AUS) was a feasible method with good accuracy and high repeatability to select patients with heavy nodal disease in the post-Z0011 trial era.

Spectrum and features of congenital heart disease in Xi'an, China as detected using fetal echocardiography.

This study aimed to investigate the spectrum and features of congenital heart disease (CHD) in Xi'an, China using fetal echocardiography. All pregnant women referred for fetal echocardiography underwent a systematic fetal echocardiographic examination. Each case of complex defects was diagnosed according to the predominant pathophysiology, and the overall frequency of each defect was recorded and classified according to its location in the fetal heart. CHD was diagnosed in 195 fetuses. The top 5 types of CHD were, in order, single ventricle (15.9%, 31/195), atrioventricular septal defect (12.3%, 24/195), ventricular septal defect (VSD) (11.8%, 23/195), tetralogy of Fallot (10.8%, 21/195), and double-outlet right ventricle (8.2%, 16/195). The 195 cases of CHD comprised 316 defects in total. The most common defect was ventricular malformation (40.5%, 128/316), followed by great artery anomalies (38.0%, 120/316), endocardial cushion abnormalities (11.7%, 37/316), atrial abnormalities (6.6%, 21/316), and semilunar valve abnormalities (3.2%, 10/316). VSD accounted for the largest proportion (24.4%, 77/316) of the ventricular malformations. The total proportion of obstructive lesions in this group was much higher for the right than for the left side of the heart (18.4% (58/316) vs 9.5% (30/316), respectively). The spectrum of fetal CHD detected by echocardiography was much different compared to that accepted in the past. Complex defects were more common prenatally. Ventricular malformations were the largest constituent of all of the defects associated with fetal CHD, and VSD was the most common component of complex defects. Chinese fetal CHD encompassed more right-sided than left-sided obstructive lesions.

Coordinated regulation of the immunoproteasome subunits by PML/RARα and PU.1 in acute promyelocytic leukemia.

Recognition and elimination of malignant cells by cytotoxic T lymphocytes depends on antigenic peptides generated by proteasomes. It has been established that impairment of the immunoproteasome subunits, that is, PSMB8, PSMB9 and PSMB10 (PSMBs), is critical for malignant cells to escape immune recognition. We report here the regulatory mechanism of the repression of PU.1-dependent activation of PSMBs by PML/RARα in the pathogenesis of acute promyelocytic leukemia (APL) and the unidentified function of all-trans retinoic acid (ATRA) as an immunomodulator in the treatment of APL. Chromatin immunoprecipitation and luciferase reporter assays showed that PU.1 directly bound to and coordinately transactivated the promoters of PSMBs, indicating that PSMBs were transcriptional targets of PU.1 and PU.1 regulated their basal expression. Analysis of expression profiling data from a large population of acute myeloid leukemia (AML) patients revealed that the expression levels of PSMBs were significantly lower in APL patients than in non-APL AML patients. Further evidence demonstrated that the decrease in their expression was achieved through PML/RARα-mediated repression of both PU.1-dependent transactivation and PU.1 expression. Moreover, ATRA but not arsenic trioxide induced the expression of PSMBs in APL cells, indicating that ATRA treatment might activate the antigen-processing/presentation machinery. Finally, the above observations were confirmed in primary APL samples. Collectively, our data demonstrate that PML/RARα suppresses PU.1-dependent activation of the immunosubunits, which may facilitate the escape of APL cells from immune surveillance in leukemia development, and ATRA treatment is able to reactivate their expression, which would promote more efficient T-cell-mediated recognition in the treatment.

Random fiber laser formed by mixing dispersion compensated fiber and single mode fiber.

Taking advantage of relatively strong Rayleigh scattering and Raman gain of dispersion compensated fiber (DCF), three configurations to form efficient random fiber lasers (RFL) are proposed in this paper. Compared with the reported RFL formed by single-mode fiber (SMF) solely, lasing threshold and length of the proposed RFL are effectively reduced through combination of DCF and SMF. In addition, FBGs with central wavelengths at the 1st and 2nd -order Raman Stokes wavelengths are also added to the hybrid SMF/DCF cavity to further reduce the lasing threshold, leading to realization of a new kind of 2nd-order RFL.

Hybrid lasing in an ultra-long ring fiber laser.

In this paper, we reported the realization of an ultra-long ring fiber laser (RFL) with hybrid emission related to both random lasing and cavity resonance. Compared with a linear random fiber laser (LRFL), the Rayleigh scattering (RS) inducting distributed feedback effect and the cavity inducting resonance effect exist simultaneously in the laser, which reduces the lasing threshold considerably and provides a hybrid way to form random lasing (RL). The laser output can be purely modeless RL when pump power is high enough. It is also discovered that the laser is insensitive to temperature variation and mechanical disturbance, this is unique and quite different from conventional RFLs which are environmentally unstable due to existence of the cavity modes.

Long-distance fiber-optic point-sensing systems based on random fiber lasers.

We find that the random fiber laser (RFL) without point-reflectors is a temperature-insensitive distributed lasing system for the first time. Inspired by such thermal stability, we propose the novel concept of utilizing the RFL to achieve long-distance fiber-optic remote sensing, in which the RFL offers high-fidelity and long-distance transmission for the sensing signal. Two 100 km fiber Bragg grating (FBG) point-sensing schemes based on RFLs are experimentally demonstrated using the first-order and the second-order random lasing, respectively, to verify the concept. Each sensing scheme can achieve >20 dB optical signal-to-noise ratio (OSNR) over 100 km distance. It is found that the second-order random lasing scheme has much better OSNR than that of the first-order random lasing scheme due to enhanced lasing efficiency, by incorporating a 1455 nm FBG into the lasing cavity.

Investigation on genetic traits and selection of interspecific somatic hybrid progenies in tobacco.

The interspecific somatic hybrid plants were produced in 1980 by protoplast fusions between N. tabacum and N. rustica, and N. tabacum and N. glauca. The results of this study on the genetic traits and selection of the hybrid progenies for seven years showed that the performances of the somatic hybrids (SH) were typical intermediate forms of the two species involved in each somatic hybridization, and that segregation began in SH3 and (SH)BC2 generations (the SH1 backcrossed to N. tabacum twice). However, stable lines and male sterile lines from SH1 until the present, were also obtained. The fertilities of the hybrid progenies were generally poor. The characteristics of the recurrent parent were accumulated, and the chromosome numbers of the hybrid plants were gradually decreased as the number of backcrossing generations increased. Some new types of tobacco with certain commercial values have been selected for used in the present study. The conclusion reached, based on our results, is that the somatic hybridization technology has now been successfully utilized to create unique breeding lines of tobacco, and represents a powerful, new tool for crop improvement.

[Application of monoclonal antibody OC 125 in gynecological oncology].

This study was undertaken to determine whether the measurement of CA125 could effect an early diagnosis and a method for monitoring the course of gynecologic tumors. CA 125 in serum of 195 patients, including 15 apparently healthy women; 39 benign gynecologic tumors; 2 borderline ovarian tumors; 139 malignancies were measured by CENTOCOR cancer antigen 125 kits. Diagnosis of all patients was confirmed by pathology. None of the healthy women; 10% of benign tumors; 78% of epithelial ovarian cancers; 31% of endometrial adenocarcinomas and one out of five adenocarcinoma of uterine cervix had CA 125 level over 65 U/ml. In addition, 23 cases of ovarian cancer were monitored serially up to 9 months. In more than 80% of these patients, CA 125 levels were correlated with the regression or progression of the disease. The significance of this assay for early diagnosis and monitoring the course of ovarian cancer is discussed. It is considered that CA 125 is a promising and useful antigenic marker for monitoring the course of ovarian cancers.