Clinical Application of Thoracoscopic Resection of Anterior Mediastinal Tumors under the Xiphoid Process.

Objective: To explore the feasibility and advantages of thoracoscopic resection of anterior mediastinal tumors through subxiphoid and lateral thoracic approaches. Method: 74 patients with anterior mediastinal tumors hospitalized in our hospital from January 2019 to January 2022 were retrospectively analyzed. They were divided into the lateral chest group (31 cases) and the infraxiphoid group (43 cases) according to different operation methods. The tumor size, operation time, intraoperative bleeding, postoperative pain score, postoperative complications, postoperative drainage tube removal time, and hospital stay were compared between the two groups. Result: The intraoperative bleeding and postoperative pain scores in the subxiphoid group were better than those in the lateral chest group. There was no significant difference in operation time and postoperative complications between the two groups. Conclusion: Compared with the lateral thoracic approach, the thoracoscopic subxiphoid approach can be more safe and effective in resectioning anterior mediastinal tumors.

Rapid death due to pulmonary epithelioid haemangioendothelioma in several weeks: A case report.

A 49-year-old woman was admitted to our hospital because of haemoptysis for 6 days. This patient claimed no medical history except high blood sugar. Chest computed tomography (CT) showed infection and multiple nodules on both sides of the lung. Blood tests showed no obvious abnormalities. Tracheoscopy showed haemorrhagic discharge in the left upper lobe and an old thrombus obstructing the lumen in the anterior basal segment of the right lower lobe. Then, CT-guided percutaneous lung biopsy was performed. The pathological results suggested multiple nodular-like lesions in the submitted tissues, and tumour cells were round or short fusiform, forming a solid nest structure, visible mitosis, and a vascular cavity-like structure containing red blood cells. Immunohistochemistry revealed positive staining for Vimentin, Bcl-2, CD31, and CD34; negative staining for CD68, SMA, CR, and D2-40; and 40% Ki67+ positivity. Based on the earlier data, the patient was diagnosed with pulmonary epithelioid haemangioendothelioma. This patient did not receive any treatment for several reasons. Unfortunately, the patient died 8 weeks after diagnosis. In conclusion, we present a case featuring the rapid death due to PEH.

Dynamic generation and modulation of acoustic bottle-beams by metasurfaces.

Acoustic bottle-beams have been realized by acoustic metasurfaces (AMs) composed of space-coiling subunits. By manipulating the transmitted acoustical phase, the special AM can generate two intersecting accelerating beams along the designed convex trajectories, forming the acoustic bottle-beam. The transmitted acoustic bottle-beams are investigated theoretically and demonstrated numerically. We find that the shape and area of the acoustic bottle-beam could be statically controlled by designing the AM as well as dynamically modulated by the incident angles. In addition, the highly efficient acoustic focusing could be obtained at the convergence point of the bottle-beams, which also could be adjusted dynamically by the incident angles. It is further found that this focusing is robust against the obstacle scattering. The realization and manipulation of acoustic bottle-beams may have potential applications in biomedical imaging/therapy and non-destructive evaluation.

Broadband acoustic subwavelength imaging by rapidly modulated stratified media.

An acoustic anisotropic lens (AAL) based on large mass-density modulation depth (LMMD) medium is proposed for subwavelength imaging. The underlying mechanism for converting evanescent components into propagating waves is attributed to the strong suppression of the transverse velocity field component in LMMD medium. In addition, the proposed lens can operate in a broadband manner, which is more flexible in practical applications. Both transfer matrix method and finite element method are used to corroborate the subwavelength imaging capabilities of the proposed lens. The numerical simulations demonstrate that the proposed lens can clearly distinguish two Gaussian sources with equal width of λ0/25 and separation of λ0/5 in a broad frequency bandwidth. Medium losses decrease the transmission but cannot compromise the resolution of the lens.

Non-diffraction propagation of acoustic waves in a rapidly modulated stratified medium.

A rapidly modulated stratified medium with a large mass density modulation depth (LMMD) is proposed to achieve non-diffraction propagation (NDP) of acoustic waves. It is found that the NDP in LMMD medium is independent of the incident angle and can be operated in a broad-band manner. Such an NDP is robust and is unhampered by medium losses. An effective medium theory (EMT) is developed for acoustic waves propagating in the LMMD medium based on the first-principles method. The LMMD EMT is verified by using the transfer-matrix method (TMM) for both propagating and evanescent waves. Furthermore, we discuss the influence of the geometry on NDP, and finite element simulations are conducted to verify the NDP in the LMMD medium.

Serum thymidine kinase 1 levels correlate with clinical characteristics of esophageal squamous cell carcinoma.

Patients with esophageal cancer are often diagnosed at advanced stages, leading to poor prognosis. Biomarkers are needed to enable earlier detection as well as to aid in the prediction of prognosis, but to date these tools remain scarce. Thymidine kinase (TK1) has been shown to exhibit altered expression levels in esophageal tumor cells, therefore this study sought to determine whether serum TK1 levels are also altered and, if so, to assess the utility of TK1 as a biomarker in esophageal squamous cell carcinoma. Eighty patients with esophageal squamous cell carcinoma were included as the case group and 80 healthy persons were selected as the control group. Serum TK1 levels, postoperatively for cancer patients, were detected by chemiluminescence. Follow-up was performed for cancer patients to determine the progression free survival (PFS) and overall survival (OS). Serum TK1 levels were significantly higher in cases of esophageal cancer than in healthy control individuals (t=7.235, P<0.05). When cancer cases were sub-divided into lower and higher serum TK1 levels, based on the mean level of 3.38 pmol/L, statistically significant differences in TNM stage, tumor differentiation, and lymph node metastasis were observed between patients with ≥3.38 pmol/L and <3.38 pmol/L (χ(2)=28.134, 3.187, 7.234, P<0.05). The average OS of all esophageal cancer patients was 30.13 months, and the average PFS was 24.73 months. However, when the cases were divided by serum TK1 level, average OS of those with higher serum TK1 (≥3.38 pmol/L) was significantly lower (23.98 mo) than those with lower serum TK1 (32.96 mo) (χ(2)=5.439, P<0.05). Similarly, average PFS was significantly lower in patients with higher serum TK1 (17.65 mo versus 27.62) (χ(2)=4.640, P<0.05). OS was correlated with TNM stage (hazard ratio, HR=3.116), degree of tumor differentiation (HR=0.427), lymph node metastasis (HR=0.535), and serum TK1 level (HR=1.913) (Wald χ(2)=6.782, 6.228, 4.562, 5.681, P<0.05). Similarly, PFS was correlated with TMN stage (HR=2.153), degree of tumor differentiation (HR=0.627), and serum TK1 level (HR=1.632) (Wald χ(2)=7.035, 5.335, 4.887, P<0.05). Thus, patients with esophageal squamous cell carcinoma exhibit higher circulating TK1 levels, consistent with findings of increased TK1 expression in tumor cells. Further, the correlation of serum TK1 levels with clinical features of esophageal cancer and with patient survival suggest that serum TK1 may serve as a valuable biomarker for predicting patient prognosis.

The interaction between Toll-like receptor 4 signaling pathway and hypoxia-inducible factor 1α in lung ischemia-reperfusion injury.

BACKGROUND: Lung ischemia-reperfusion injury (LIRI) is the life-threatening complication occurring after lung transplantation. Toll-like receptor 4 (TLR4) signaling pathway and hypoxia-inducible factor-1α (HIF-1α) are intimately involved in the development and progression of various inflammatory and hypoxia diseases; however, the relationship of them in LIRI in vivo is still far from clear. MATERIALS AND METHODS: Forty-five Sprague-Dawley rats were randomly distributed in nine groups: (1) Sham group, (2) LIRI group, (3) LIRI + saline control group, (4) LIRI + dimethyl Sulfoxide control group, (5) LIRI + lipopolysaccharide group, (6) LIRI + TAK-242 group (TAK-242 is a TLR4 inhibitor, ethyl (6R)-6- [N-(2-chloro-4-fluorophenyl)sulfamoyl]cyclohex-1-ene-1-carboxylate), (7) LIRI + thioredoxin group (thioredoxin is an apoptosis signal-regulating kinase 1 (ASK1) inhibitor), (8) LIRI + SB203580 group (SB203580 is a p38 inhibitor), and (9) LIRI + chetomin group (chetomin is a HIF-1α inhibitor). The interaction between TLR4 signaling pathway (including TLR4, myeloid differentiation primary response gene 88 (MyD88), TIR-domain-containing adapter-inducing interferon-ß (TRIF), ASK1, and p38) and HIF-1α and the role of TLR4-dependent HIF-1α were analyzed. RESULTS: In LIRI, HIF-1α accumulation was induced in a TLR4-dependent fashion, and MyD88, but not TRIF, and activation of ASK1 and p38 were found to be critical for TLR4-mediated HIF-1α accumulation. HIF-1α protein played a critical role in TLR4-mediated lung injury of LIRI (including inflammation, cell apoptosis, and lung damage). HIF-1α protein upregulated TLR4 expression of LIRI in a positive feedback manner. CONCLUSIONS: We identify that the TLR4-HIF-1 loop may be existed in LIRI. Therefore, we suggest that the interaction between them may represent a novel therapeutic target for the development of novel target-based therapies of LIRI.

[Lung transplantation for silicosis: a report of 5 cases].

OBJECTIVE: To investigate the selection of recipients, operative technique, and perioperative management of lung transplantation for silicosis. METHODS: Lung transplantations (LTx) were performed for five end-stage silicosis in our hospital who were diagnosed in accordance with recommendations of the local Prophylactic Therapeutic Institution for Occupational Diseases. The chest roentgenogram and high resolution CT showed somewhat pulmonary interstitial fibrosis, pulmonary emphysema and massive opacities. The mean pulmonary artery pressure (mPAP) was > 30mmHg, NYHA III or IV. Two patients received thoracic surgery prior to LTx, one patient was ventilator-dependent. One patient received bilateral sequence lung transplantation (BSLT) under extracorporeal membrane oxygenation (ECMO) support. Four patients received single lung transplantation (SLT), 3 under ECMO support. RESULTS: Patient five died of multiple organ failure on postoperative day 8, the remaining four patients were discharged from hospital. During follow up, patient three died of severe infection 7 month postoperatively, the remaining three patients were alive for 5 years, 3 years and 2 years respectively, and lived good quality of life, especially with lower mPAP and improved lung function. Although our patients suffered low-grade chronic rejection with the manifestation of bronchiolitis obliterative syndrome (BOS). CONCLUSION: Lung transplantation is a viable option for patients with end-stage silicosis, providing acceptable quality of life and survival. Both SLT and BSLT are satisfactory approach for end-stage silicosis,and long-term survival requires further investigations.

Photoperiodic counter of diapause induction in Pseudopidorus fasciata (Lepidoptera: Zygaenidae).

Induction of larval diapause is a photoperiodically controlled event in the life history of the moth Pseudopidorus fasciata. In the present study, the photoperiodic counter of diapause induction has been systematically investigated. The required day number (RDN) for a 50% response was determined by transferring from a short night (LD 16:8) to a long night (LD 12:12) or vice versa at different times after hatching, The RND differed significantly between short- and long-night cycles at different temperatures. The RDN for long-night cycles at 20, 22, 25 and 28 degrees C was 11.5, 9.5, 7.5 and 8.5 days, respectively. The RDN for short-night cycles was 3 days at 22 degrees C and 5 days at 20 degrees C indicating that the effect of one short night was equivalent to the effect of 2-3 long nights effect. Night-interruption experiments of 24h photoperiods by a 1 h light pulse showed that the most crucial event for the photoperiodic time measurement in this moth was whether the length of pre-interruption (D(1)) or the post-interruption (D(2)) scotophases exceeded the critical night length (10.5 h). If D(1) or D(2) exceeded 10.5 h diapause was induced. The diapause-averting effect of a single short-night cycle (LD 16:8) against a background of long nights (LD 12:12) showed that the photoperiodic sensitivity was greatest during the first 7 days of the larval period and the highest sensitivity was on the fourth day. Both non-24 and 24 h light-dark cycle experiments revealed that the photoperiodic counter in P. fasciata is able to accumulate both long and short nights during the photosensitive period, but in different ways. The information from short-night cycles seems to be accumulated one by one in contrast to long-night cycles where six successive cycles were necessary for about 50% diapause induction and eight cycles for about 90% diapause. These results suggest the accumulation of long-night and short-night cycles may be based on different mechanisms.