ABSTRACT
Surgical operation is one of the significant parts of the comprehensive therapeutic methods of lung cancer. In the history of the development of lung cancer operation, scholars and predecessors at home and abroad have gradually established the current status of lung cancer operation and the framework of comprehensive treatment after continuous understanding of local anatomy of lung, continuous innovation of surgical equipment and continuous reform of surgical methods. In the continuous development and improvement of lung cancer surgical diagnosis and treatment procedures, a set of standardized diagnosis and treatment process of lung cancer screening, early diagnosis and treatment, standardized surgery process, rapid perioperative recovery, postoperative adjuvant treatment and follow-up has been formed. The achievements of lung cancer operation are achieved by scholars standing on the shoulders of giants. In the process of pioneering and innovating, we should go back and review the road that our predecessors have taken, and draw energy from it to continue to create new brilliance in lung cancer operation. In this paper, the evolution history of lung cancer surgery is summarized in order to improve the clinician's understanding of the history of lung cancer surgery.
Subject(s)
Lung Neoplasms , Humans , Lung Neoplasms/surgery , Early Detection of Cancer , LungABSTRACT
Objective: To investigate the incidence and trend of short-term outcomes among preterm infants born <34 weeks' gestation. Methods: A secondary analysis of data from the standardized database established by a multicenter cluster-randomized controlled study "reduction of infection in neonatal intensive care units (NICU) using the evidence-based practice for improving quality (REIN-EPIQ) study". This study was conducted in 25 tertiary NICU. A total of 27 192 infants with gestational age <34 weeks at birth and admitted to NICU within the first 7 days of life from May 2015 to April 2018 were enrolled. Infants with severe congenital malformation were excluded. Descriptive analyses were used to describe the mortality and major morbidities of preterm infants by gestational age groups and different admission year groups. Cochran-Armitage test and Jonckheere-Terpstra test were used to analyze the trend of incidences of mortality and morbidities in 3 study-years. Multiple Logistic regression model was constructed to analyze the differences of outcomes in 3 study-years adjusting for confounders. Results: A total of 27 192 preterm infants were enrolled with gestational age of (31.3±2.0) weeks at birth and weight of (1 617±415) g at birth. Overall, 9.5% (2 594/27 192) of infants were discharged against medical advice, and the overall mortality rate was 10.7% (2 907/27 192). Mortality for infants who received complete care was 4.7% (1 147/24 598), and mortality or any major morbidity was 26.2% (6 452/24 598). The incidences of moderate to severe bronchopulmonary dysplasia, sepsis, severe intraventricular hemorrhage or periventricular leukomalacia, proven necrotizing enterocolitis, and severe retinopathy of prematurity were 16.0% (4 342/27 192), 11.9% (3 225/27 192), 6.8% (1 641/24 206), 3.6% (939/25 762) and 1.5% (214/13 868), respectively. There was a decreasing of the overall mortality (P<0.001) during the 3 years. Also, the incidences for sepsis and severe retinopathy of prematurity both decreased (both P<0.001). However, there were no significant differences in the major morbidity in preterm infants who received complete care during the 3-year study period (P=0.230). After adjusting for confounders, infants admitted during the third study year showed significantly lower risk of overall mortality (adjust OR=0.62, 95%CI 0.55-0.69, P<0.001), mortality or major morbidity, moderate to severe bronchopulmonary dysplasia, sepsis and severe retinopathy of prematurity, compared to those admitted in the first study year (all P<0.05). Conclusions: From 2015 to 2018, the mortality and major morbidities among preterm infants in Chinese NICU decreased, but there is still space for further efforts. Further targeted quality improvement is needed to improve the overall outcome of preterm infants.
Subject(s)
Gestational Age , Infant, Premature, Diseases , Patient Discharge , Bronchopulmonary Dysplasia/epidemiology , Humans , Infant , Infant Mortality/trends , Infant, Newborn , Infant, Premature , Infant, Premature, Diseases/epidemiology , Retinopathy of Prematurity/epidemiology , Sepsis/epidemiologyABSTRACT
Objective: To evaluate the role of combining relative alpha variability and electroencephalogram (EEG) reactivity to predict the prognosis of hypoxic-ischemic encephalopathy(HIE) in adult patients. Methods: A total of 28 adult patients with HIE admitted to general intensive care unit at Xiangya Hospital in Central South University were enrolled in this observational study from January2016 to April 2017. These patients with body temperature over 35â after 72-hour admission could be continuously monitored at least 12 hours byEEG.At the same time,each patient was assessed for EEG reactivity.Then we analyzed the correlation between EEG reactivity, relative alpha variability and clinical prognosis. Results: EEG reactivity was elicited in 15/28 patients, among whom 12 patients had a good outcome. While in the other 13 patients, EEG reactivity was not elicited, among whom only 3 patients had a good outcome. As to the results ofrelative alpha variability,11/13 patients with degree 3-4were of good prognosis; while only 3/15 patients with degree 1-2 were of good prognosis. Glasgow coma scale(GCS), EEG reactivity, and relative alpha variability were correlated with clinical outcome(χ(2)=5.073,9.073,-3.626, respectively,all P<0.05). The sensitivity of GCS, EEG reactivity, and relative alpha variability to predict the poor prognosis were 69.2%, 76.9%, 84.6%, respectively. The specificity were 73.3%, 80.0%, 73.3%, respectively. The consistency rates were 71.4%, 78.6%, 78.6%, respectively. The positive predictive values were 69.2%, 76.9%, 73.3%, respectively. The negative predictive values were 73.3%, 80.0%, 84.6%, respectively. More importantly, the accuracy of the relative alpha variability combined with EEG reactivity for the prediction of poor prognosis was much higher with the positive predictive value of 90.0%,the specificity of 93.3%, the sensitivity of 69.2%, the consistency rate of 82.1%,and the negative predictive values of 77.8%. Conclusions: The combination of relative alpha variability and EEG reactivityis reliable to predict clinical outcome of patients with HIE.
Subject(s)
Electroencephalography , Hypoxia-Ischemia, Brain/diagnosis , Adult , Glasgow Coma Scale , Humans , Predictive Value of Tests , Prognosis , Sensitivity and SpecificityABSTRACT
This study investigates the anti-cancer potential of Aclidinium bromide (INN) in glioblastoma. Glioblastoma cell lines U251 and U87 were treated with INN and its effects on cell migration and invasion were assessed by transwell migration and invasion assays., The effects of INN on proliferation and apoptosis were detected by CCK-8 kit and flow cytometry, and Western blotting determined anti-apoptotic proteins and signaling pathway changes. The results show that INN effectively suppressed proliferation, migration and invasion and induced apoptosis in U251 and U87 cells, respectively. Furthermore, the expression levels of the Bcl-2 anti-apoptotic protein was significantly decreased while Bax and caspase-3 expression were both increased in glioblastoma cells (all, p<0.05). Moreover, INN inactivated the PI3K/AKT signaling pathway by down-regulating the level of p-AKT, p-mTOR, P70 and CyclinD1 (all, p<0.05). In conclusion, our data suggests that INN could provide novel anticancer therapy in the treatment of glioblastoma.
Subject(s)
Glioma/pathology , Phosphatidylinositol 3-Kinases , Proto-Oncogene Proteins c-akt , Signal Transduction/drug effects , Tropanes/pharmacology , Apoptosis , Cell Line, Tumor , Cell Movement , Cell Proliferation , Humans , Neoplasm InvasivenessABSTRACT
We investigated the impact and signal transduction mechanisms of epigallocatechin-3-gallate (EGCG) on transdiffer-entiation of renal tubular epithelial cells. Rat renal tubular epithelial cells (NRK-52E) were randomly divided into a normal control group, transforming growth factor (TGF)-b1-induced group (10 ng/mL), and intervention groups with 200 mg/L EGCG + 10 ng/mL TGF-b1 and 400 mg/L EGCG + 10 ng/mL TGF-b1. Tested cells were collected after 48 h. Levels of a-smooth muscle actin (α-SMA) and cytokeratin-18 were detected using immunohistochemical methods. Western blotting was used to detect cytoplasmic Pi-extracellular receptor kinase 1/2 (ERK1/2), Pi-Smad3 protein, and nuclear b-catenin protein. mRNA expression of ERK2, Smad3, and ß-catenin was measured by reverse transcription-polymerase chain reaction. After induction by TGF-b1, cytokeratin-18 expression in the renal tubular epithelial cells decreased and a-SMA expression appeared. mRNA expression of cytoplasmic Pi-Smad3 and Pi-ERK1/2, Smad3, ERK2, and b-catenin protein expression increased, while ß-catenin mRNA decreased. These changes were reduced after intervention by EGCG. EGCG may be helpful for maintaining the renal tubular epithelial cell phenotype and reducing the degree of TGF-b1- induced cell transdifferentiation, which may be related to the signal transduction pathway of ERK, Smad3, and ß-catenin.
Subject(s)
Catechin/analogs & derivatives , Epithelial Cells/drug effects , Epithelial-Mesenchymal Transition/drug effects , Kidney Tubules/drug effects , Protective Agents/pharmacology , Signal Transduction/drug effects , Animals , Catechin/pharmacology , Cell Line , Extracellular Signal-Regulated MAP Kinases/genetics , Extracellular Signal-Regulated MAP Kinases/metabolism , Gene Expression , Rats , Smad3 Protein/genetics , Smad3 Protein/metabolism , beta Catenin/genetics , beta Catenin/metabolismABSTRACT
Gluteal muscle contracture (GMC) is a chronic fibrotic disease of gluteal muscles due to multiple etiologies. The main pathologic process is characterized by proliferation of fibroblasts and excessive accumulation of collagen in the extracellular matrix of the muscle. Sphingosine-1-phosphate (S1P) is a bioactive sphingolipid and has been reported to be associated with various fibrotic diseases. However, the role of S1P in GMC remains unknown. Here in this article, High-performance liquid chromatography and immunohistochemistry were applied to evaluate S1P localization and expression in clinical samples from patients with GMC, Quantitative real time PCR, Western blot, and enzyme-linked immunosorbent assay were used to explore the link between transforming growth factor-beta1 (TGF-beta1), plasminogen activator inhibitor-1 (PAI-1) and S1P. The results showed that S1P was enhanced in contraction band (CB) tissues. Studies using the cell proliferation and transformation assay indicated that exogenous S1P stimulated CB fibroblast proliferation in a time-dependent manner and in higher concentration also in a dose-dependent manner. Furthermore, we demonstrated that S1P not only promoted collagen type I production, but also up-regulated mRNA and protein expression of transforming growth factor-beta1 and plasminogen activator inhibitor-1. These findings suggest that S1P may regulate increased synthesis of collagen and other fibrogenic factors, and significantly contributes to the process of gluteal muscle scarring in patients with GMC.
Subject(s)
Contracture/metabolism , Fibrinolytic Agents/metabolism , Lysophospholipids/metabolism , Muscle, Skeletal/metabolism , Muscle, Skeletal/pathology , Sphingosine/analogs & derivatives , Adolescent , Adult , Buttocks/pathology , Child , Contracture/pathology , Female , Fibrosis/metabolism , Humans , In Vitro Techniques , Male , Sphingosine/metabolism , Young AdultABSTRACT
AIMS: To explore new resources of methane-utilizing micro-organism and develop a microbial biosensing system for monitoring methane released from natural and semi-natural ecosystems. METHODS AND RESULTS: A methane (CH(4))-utilizing bacterial strain was isolated from paddy soil using CH(4) as the sole carbon source and identified as Klebsiella sp. ME17 by phenotyping and 16S rDNA sequence analysis. The efficiency of CH(4) utilization of strain ME17 was 83.2% by gas chromatography analysis. A microbial biosensing system for CH(4) detection was developed by combining immobilized cells of strain ME17 with a dissolved oxygen sensor. It was found that response time of the system to CH(4) was <90s. The dissolved O(2) consumption increased with increasing CH(4) from 0% to 16.0% (v/v) demonstrating a positive linear relationship with a low detection limit of 0.2% (v/v). The relative standard deviation is 3.48%. CONCLUSIONS: Klebsiella sp. ME17 isolate is capable of utilizing CH(4). The microbial biosensing system of strain ME17 has been successfully applied to measure standard CH(4) sample with satisfactory results. SIGNIFICANCE AND IMPACT OF THE STUDY: This study suggests that certain strains of Klebsiella genus are capable of utilizing CH(4). Our proposed method appears very attractive for CH(4) measurement in coal mine.
Subject(s)
Klebsiella/metabolism , Methane/analysis , Methane/metabolism , Chromatography, Gas , Klebsiella/genetics , Klebsiella/growth & development , Klebsiella/isolation & purification , Methane/pharmacology , Oxygen/metabolism , Phenotype , Polymerase Chain Reaction , RNA, Ribosomal, 16S/genetics , Sequence Analysis, DNA , Soil Microbiology , Time FactorsABSTRACT
Gabor schemes of image representation have shown great success in many texture related computer vision applications. This is mainly because the primitives of image representation in vision have a wavelet form similar to Gabor elementary functions (GEF's). We use Gabor approach to analyze the texture of liver CT-images and extract the corresponding feature vectors. Then, the feature vectors are used to facilitate content-based image retrieval (CBIR). In experiments, a batch of liver CT images containing several types of CT findings is collected, and retrieval results by Gabor texture are present.
ABSTRACT
The reaction of nitrobenzylic carbanions with dimethyldioxirane (DMD) results in oxidation at the carbanion center or at the nitronate center to give nitrobenzylic carbinols or quinomethanes, respectively. Minor amounts of the methylation products are also formed. Both of these processes were observed for carbanions of (p-nitroaryl)diarylmethanes. The outcome of the oxidation process is very sensitive to the reaction conditions.