Molecular Triplet Generation Enabled by Adjacent Metal Nanoparticles.

High-efficiency generation of spin-triplet states in organic molecules is of great interest in diverse areas such as photocatalysis, photodynamic therapy, and upconversion photonics. Recent studies have introduced colloidal semiconductor nanocrystals as a new class of photosensitizers that can efficiently transfer their photoexcitation energy to molecular triplets. Here, we demonstrate that metallic Ag nanoparticles can also assist in the generation of molecular triplets in polycyclic aromatic hydrocarbons (PAHs), but not through a conventional sensitization mechanism. Instead, the triplet formation is mediated by charge-separated states resulting from hole transfer from photoexcited PAHs (anthracene and pyrene) to Ag nanoparticles, which is established through the rapid formation and subsequent decay of molecular anions revealed in our transient absorption measurements. The dominance of hole transfer over electron transfer, while both are energetically allowed, could be attributed to a Marcus inverted region of charge transfer. Owing to the rapid charge separation and the rapid spin-flip in metals, the triplet formation yields are remarkably high, as confirmed by their engagement in production of singlet oxygen with a quantum efficiency reaching 58.5%. This study not only uncovers the fundamental interaction mechanisms between metallic nanoparticles and organic molecules in both charge and spin degrees of freedom but also greatly expands the scope of triplet "sensitization" using inorganic nanomaterials for a variety of emerging applications.

Ecological risk assessment of dissolved heavy metals in the Yangtze River Estuary and Zhejiang coastal waters, China.

The study applied a tiered ecological risk assessment method to evaluate the long-term status and trend of the ecological risks of dissolved heavy metals from 2011 to 2019 in the Yangtze River Estuary and Zhejiang coastal waters, China. The results for spring, summer, and autumn of 2019 indicated that Pb, Cd, and Zn posed no adverse ecological risk, Cu posed a potential ecological risk, and As posed an ecological risk. The annual results from 2011 to 2019 suggested that Pb, Cd, and Zn posed no adverse ecological risks, and As and Cu posed an ecological risk. The trend analysis in the nine years showed that the ecological risk of Cu is gradually decreasing, while that of As is still a concern. The overall trend is attributed to the environmental protection policies that reduced these contaminants' terrestrial sources and atmospheric sources.

Linkage-Mediated Electronic Structure Modulation in Multicomponent Covalent Organic Frameworks for Dramatically Promoted Photocatalytic Hydrogen Evolution.

Linkage chemistry is an essential aspect to covalent organic framework (COF) applications; it is highly desirable to precisely modulate electronic structure mediated directly by linkage for efficient COF-based photocatalytic hydrogen evolution, which however, remains substantially challenging. Herein, as a proof of concept, a collection of robust multicomponent pyrene-based COFs with abundant donor-acceptor (D-A) interactions has been judiciously designed and synthesized through molecularly engineering linkage for photogeneration of hydrogen. Controlled locking and conversion of linkage critically contribute to continuously regulating COFs' electronic structures further to optimize photocatalytic activities. Remarkably, the well-modulated optoelectronic properties turn on the average hydrogen evolution rate from zero to 15.67 mmol g-1 h-1 by the protonated quinoline-linked COF decorated with the trifluoromethyl group (TT-PQCOF-CF3). Using diversified spectroscopy and theoretical calculations, we show that multiple modifications toward linkage synergistically lead to the redistribution of charge on COFs with extended π-conjugation and reinforced D-A effect, making TT-PQCOF-CF3 a promising material with significantly boosted carrier separation and migration. This study provides important guidance for the design of high-performance COF photocatalysts based on the strategy of linkage-mediated electronic structure modulation in COFs.

Interfacial Bonding Induced Charge Transfer in Two-Dimensional Amorphous MoO3-x/Graphdiyne Oxide Non-Van der Waals Heterostructures for Dominant SERS Enhancement.

Two-dimensional semiconductor-based nanomaterials have shown to be an effective substrate for Surface-enhanced Raman Scattering (SERS) spectroscopy. However, the enhancement factor (EF) tends to be relatively weak compared to that of noble metals and does not allow for trace detection of molecules. In this work, we report the successful preparation of two-dimensional (2D) amorphous non-van der Waals heterostructures MoO3-x/GDYO nanomaterials using supercritical CO2. Due to the synergistic effect of the localized surface plasmon resonance (LSPR) effect and the charge transfer effect, it exhibits excellent SERS performance in the detection of methylene blue (MB) molecules, with a detection limit as low as 10-14 M while the enhancement factor (EF) can reach an impressive 2.55×1011. More importantly, the chemical bond bridging at the MoO3-x/GDYO heterostructures interface can accelerate the electron transfer between the interfaces, and the large number of defective surface structures on the heterostructures surface facilitates the chemisorption of MB molecules. And the charge recombination lifetime can be proved by a ~1.7-fold increase during their interfacial electron-transfer process for MoO3-x/GDYO@MB mixture, achieving highly sensitive SERS detection.

Pressure Coupled Lanthanide Ion Doping to Enhance Optical Properties in BaTiO3.

Self-trapped excitons (STEs) typically give broadband photoluminescence emission with a large Stokes shift, which is important for the enhancement of the optical properties of materials. Here, low-dimensional La-doped BaTiO3 nanocrystals with defects are prepared using supercritical CO2 (SC CO2). The generation of the STEs is facilitated by doping La3+ ions and introducing CO2 pressure, which effectively enhance the luminescence intensity of BaTiO3. This discovery shows that the La ion doping concentration can modulate the photoluminescence of BaTiO3 nanocrystals under pressure. This work deepens the understanding of the influence of rare-earth-doped luminescent materials under pressure and provides insight to improve the capabilities of optical devices.

WHO histological classification and tumor size are predictors of the locally aggressive behavior of thymic epithelial tumors.

OBJECTIVE: The aim of this study was to explore the influencing factors that affect the local invasive behavior of thymic epithelial tumors (TETs). METHOD: We retrospectively analyzed 524 patients with TETs who underwent surgical treatment at our center from January 2010 to January 2022. Cox regression analysis was applied to identify predictors associated with the prognosis of TET. Logistic regression analysis was used to analyze the factors associated with the locally invasive behavior of TETs. Receiver operating characteristic analysis and the Youden index were applied to determine the predictive efficiency and cutoff value. RESULTS: There were 275 males and 249 females with a median age of 56 years. Seventy-seven patients had locally invasive behavior. The prognosis of local invasive TETs was significantly worse that of noninvasive TETs (P < 0.001). WHO classification and tumor size were two hazard factors for tumor invasive behavior. The risk of local invasion increased by 2.196 (OR (95 % CI): 1.813-2.659) times for each grade in WHO classification with a change from type A to thymic carcinoma. The tumor size cutoff of 6 cm represented a distinct boundary in predicting the hazard of local invasion (AUC: 0.784, specificity: 0.711, sensitivity: 0.726). CONCLUSION: WHO classification and tumor size are important factors in predicting the locally aggressive behavior of TETs. The invasion capability of TETs is constantly increasing with an escalation in WHO classification. Tumors greater than 6 cm in size have a higher risk for local invasion.

ASCC3 promotes the immunosuppression and progression of non-small cell lung cancer by impairing the type I interferon response via CAND1-mediated ubiquitination inhibition of STAT3.

BACKGROUND: Activating signal cointegrator 3 (ASCC3) has been identified as an oncogenic factor that impairs host immune defense. However, the underlying mechanisms of carcinogenesis and its impact on the antitumor immune response remain unclear. In this study, we aimed to investigate the molecular mechanisms of ASCC3 in the progression of non-small cell lung cancer (NSCLC). METHODS: Single-cell sequencing data from the Gene Expression Omnibus and gene expression profiles from The Cancer Genome Atlas database were analyzed. The expression, clinical relevance and biological functions of ASCC3 in NSCLC were explored. Then, RNA sequencing, immunoprecipitation, mass spectrometry, immunofluorescence, and flow cytometry analyses were conducted to explore the underlying molecular mechanisms. In addition, in vivo experiments in mouse models were conducted to explore the probability of ASCC3 knockdown to improve the efficacy of anti-Programmed Death-1 (PD-1) therapy in NSCLC. RESULTS: ASCC3 was significantly upregulated in NSCLC and correlated with poor pathological characteristics and prognosis in patients with NSCLC. Overexpression of ASCC3 promoted malignant phenotypes of NSCLC cells and induced an immunosuppressive tumor microenvironment, which was characterized by a decrease in CD8+ T cells, natural killer cells and dendritic cells but an increase in regulatory T(Treg) cells. Mechanistically, ASCC3 stabilized signal transducer and activator of transcription (STAT)3 signaling by recruiting Cullin-associated and neddylation dissociated 1 (CAND1), which inhibited ubiquitin-mediated degradation of STAT3, thereby impairing the type I interferon response of tumor cells and promoting the immunosuppression and progression of NSCLC. Furthermore, high expression of ASCC3 impaired the efficacy of anti-PD-1 therapy, and an anti-PD-1 antibody combined with ASCC3 knockdown exerted promising synergistic efficacy in a preclinical mouse model. CONCLUSION: ASCC3 could stabilize the STAT3 pathway via CAND1, reshaping the tumor microenvironment and inducing resistance to anti-PD-1 therapy, which promotes the progression of NSCLC. It is a reliable prognostic indicator and can be a target in combination therapy for NSCLC.

Is two-point method a valid and reliable method to predict 1RM? A systematic review.

This systematic review aimed to evaluate the reliability and validity of the two-point method in predicting 1RM compared to the direct method, as well as analyze the factors influencing its accuracy. A comprehensive search of PubMed, Web of Science, Scopus, and SPORTDiscus databases was conducted. Out of the 88 initially identified studies, 16 were selected for full review, and their outcome measures were analyzed. The findings of this review indicated that the two-point method slightly overestimated 1RM (effect size = 0.203 [95%CI: 0.132, 0.275]; P < 0.001); It showed that test-retest reliability was excellent as long as the test loads were chosen reasonably (Large difference between two test loads). However, the reliability of the two-point method needs to be further verified because only three studies have tested its reliability. Factors such as exercise selection, velocity measurement device, and selection of test loads were found to influence the accuracy of predicting 1RM using the two-point method. Additionally, the choice of velocity variable, 1RM determination method, velocity feedback, and state of fatigue were identified as potential influence factors. These results provide valuable insights for practitioners in resistance training and offer directions for future research on the two-point method.

Development of the Colorimetric and/or Fluorescent Probes for Detecting Fluoride ions in Aqueous Solution.

Fluoride ion is a strong Lewis base and one of the essential trace elements in human body. It plays a very important role in human health and ecological balance. The deficiency or excessive intake of fluoride ions will cause serious health problems, so the development of a sensitive and accurate detection method for fluoride ions is very important. The colorimetric and/or fluorescence sensing method has been a long standing attractive technique with high sensitivity and fast response. To date, most reported probes for fluoride ion are applicable only in organic solvents or organic-containing aqueous solutions. However, the probes for fluoride ion used in aqueous solution are more practically needed in view of environment protection and human health. In this paper, the materials and designing ideas of the colorimetric and/or fluorescent probes for fluoride ion based on different detection mechanisms in recent years were reviewed. Two main categories including formation of hydrogen bonds and formation of coordination covalent bonds were discussed. The latter one is further subdivided into three types, formation of B-F bond, formation of Si-F bond and formation of Mn+-F bond.

Neoadjuvant therapy with immunoagent (nivolumab) or placebo plus chemotherapy followed by surgery and adjuvant treatment in subjects with resectable esophageal squamous cell carcinoma: study protocol of a randomized, multicenter, double blind, phase II trial (NATION-2203 trial).

Background: Neoadjuvant chemotherapy (nCT) has been the recommended treatment for locally advanced esophageal squamous cell carcinoma (ESCC). The addition of programmed cell death protein 1 (PD-1) inhibitor to nCT may improve oncologic outcome and survival. However, high-level evidence of neoadjuvant immunotherapy (nIT) combined with nCT in locally advanced resectable ESCC patients are still lacking. Hence, we describe this randomized controlled trial in order to assess the efficacy and safety of neoadjuvant nivolumab in combination with chemotherapy for locally advanced (stage II-III) ESCC patients. Methods: This prospective, randomized, multicenter phase II trial aims to enroll 90 locally advanced (stage II-III) ESCC patients who will undergo nivolumab or placebo plus chemotherapy followed by surgery. Patients will be 2:1 randomized to nivolumab/chemo and placebo/chemo group by method of stratified randomization. In both arms, patients who have not achieved complete pathological complete response (pCR) will be administered with adjuvant nivolumab for up to 1 year. The primary endpoint is pCR rate and secondary endpoints include event-free survival (EFS), R0 resection rate, and adverse events (AEs). The safety will be evaluated by AEs, grading by Common Terminology Criteria for Adverse Events (CTCAE) 5.0 classifications. The double-blind will be maintained between subjects and investigators until the final unblinding process. Discussion: This protocol has been reviewed and approved by the Ethics Committee of Zhongshan Hospital (B2022-004R). This is the first prospective, multicenter, randomized controlled trial to compare the combination of immunotherapy and chemotherapy with standard chemotherapy in neoadjuvant treatment for ESCC, also to explore whether adjuvant immunotherapy offers additional benefit in non-pCR patients after nCT with/without immunotherapy and R0 resection. We hypothesize that the pCR rate, R0 resection rate, EFS and OS of the study group (nivolumab/chemo) is significantly better than those of control group. Registration: ClinicalTrial.gov: NCT05213312.

Structural Engineering of BiVO4 /CoFe MOF Heterostructures Boosting Charge Transfer for Efficient Photoelectrochemical Water Splitting.

Boosting charge separation and transfer of photoanodes is crucial for providing high viability of photoelectrochemical hydrogen (H2 ) generation. Here, a structural engineering strategy is designed and synthesized for uniformly coating an ultrathin CoFe bimetal-organic framework (CoFe MOF) layer over a BiVO4 photoanode for boosted charge separation and transfer. The photocurrent density of the optimized BiVO4 /CoFe MOF(NA) photoanode reaches a value of 3.92 mA cm-2 at 1.23 V versus reversible hydrogen electrode (RHE), up to 6.03 times that of pristine BiVO4 , due to the greatly increased efficiency of charge transfer and separation. In addition, this photoanode records one onset potential that is considerably shifted negatively when compared to BiVO4 . Transient absorption spectroscopy reveals that the CoFe MOF(NA) prolongs charge recombination lifetime by blocking the hole-transfer pathway from the BiVO4 to its surface trap states. This work sheds light on boosting charge separation and transfer through structural engineering to enhance the photocurrent of photoanodes for solar H2 production.

Clinical characteristics and progression of pre-/minimally invasive lung adenocarcinoma harboring ALK or RET rearrangements: a retrospective cohort study.

Background: Patients harboring anaplastic lymphoma kinase (ALK) or rearranged during transfection (RET) rearrangements are usually diagnosed at a relatively late stage with nodal and distant metastasis, and rapid progression course of ALK/RET fusion-positive lung cancer were well-known. However, clinical characteristics and course of pre-/minimally invasive lung adenocarcinoma harboring ALK or RET fusions are poorly described. Identifying patients with gene fusions at early stage may offer surgical options that could cure those patients. Methods: We retrospectively included patients with surgically resected pre-/minimally invasive lung adenocarcinomas harboring epidermal growth factor receptor (EGFR) mutations or ALK/RET rearrangements, and further compared the patient clinical characteristics, nodule natural course, and survival outcomes. Radiological characteristics including ground-glass component, cystic airspace, pleural attachment, etc. were specially assessed for this study. EGFR (exons 18-22) was detected by Sanger sequencing and quantitative real-time polymerase chain reaction (qRT-PCR) was used to analyze the ALK/RET rearrangements. Lung cancer-specific survival (LCSS), relapse-free survival (RFS), and overall survival (OS) were all evaluated. Results: Of 238 patients with pre-/minimally invasive lung adenocarcinomas, 226 patients had EGFR mutations, 7 patients had ALK fusions, and 5 patients had RET fusions. Average age at surgery was 45.3 years for ALK/RET-positive group and 52.6 years for EGFR-positive group (P=0.049). Radiologically, among the 12 patients with ALK/RET fusions, the majority of lesions (10/12) manifested as mixed ground-glass opacities (mGGOs), which was significantly more prevalent when compared with patients with EGFR mutations (83.4% vs. 24.3%, P<0.001). Moreover, a substantial proportion of cystic airspace was found in ALK/RET-positive group but not in EGFR-positive group (66.7% vs. 14.2%, P<0.001). Among four patients with ALK/RET fusions undergoing surveillance over 1 year before surgery, two of them developed rapid radiologic progression. The 5-year LCSS and RFS were 100%, 100% for ALK/RET-positive group, and 100%, 100% for EGFR-positive group, respectively. Conclusions: ALK/RET-positive pre-/minimally invasive lung adenocarcinomas were mostly characterized as mGGOs with cystic airspace developing rapid nodule progression, and no recurrence occurred during long-term follow-up after resection. This provides insights into proper curative surgery timing in the management of patients with gene fusions. However, these findings must be treated with caution and validated in future multi-center studies with larger sample size.

Application of 24 h Dynamic Electrocardiography in the Diagnosis of Asymptomatic Myocardial Ischemia with Arrhythmia in Elderly Patients with Coronary Heart Disease.

Objective: To investigate the application effect of 24 h dynamic electrocardiogram in the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with coronary heart disease. Methods: A total of 206 elderly patients suspected of coronary heart disease (CHD) with asymptomatic myocardial ischemia and arrhythmia were selected as the research subjects. 24 h dynamic electrocardiogram and conventional electrocardiogram examinations were conducted. Coronary angiography was used as the gold standard to observe the performance of the two examination methods in the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with CHD. Results: Coronary angiography showed 174 positive cases and 32 negative cases among the 206 patients. The diagnostic results of a conventional electrocardiogram showed 150 positive cases and 20 negative cases. Its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 86.21%, 62.50%, 82.52%, 92.59%, and 45.45%, respectively. The diagnostic results of 24 h dynamic electrocardiograms showed 168 positive cases and 29 negative cases. Its sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were 96.55%, 96.63%, 95.63%, 98.25%, and 82.86%, respectively. The above results indicated that 24 h dynamic electrocardiogram was significantly better (P < 0.05). The detection rate of arrhythmia types by 24-hour dynamic electrocardiogram was significantly higher than that of conventional electrocardiogram (P < 0.05). Conclusion: 24 h dynamic electrocardiogram is helpful for the diagnosis of asymptomatic myocardial ischemia with arrhythmia in elderly patients with CHD and can improve the detection rate, thereby providing a basis for clinical diagnosis and treatment.

Achiral-Core-Metal Change in Isomorphic Enantiomeric Ag12Ag32 and Au12Ag32 Clusters Triggers Circularly Polarized Phosphorescence.

Understanding how the chiral or achiral section in chiral nanostructures contributes to circularly polarized light emission (CPLE) at the atomic level is of fundamental importance. Here, we report two pairs of atomically precise enantiomers of homosilver (R/S-Ag12Ag32) and heterometal (R/S-Au12Ag32) clusters. The geometrical chirality of R/S-Ag12Ag32 arises from the chiral ligand and interface consisting of positive moieties of Ag32(R/S-PS)24. The circular dichroism of R/S-Ag12Ag32 is active, but CPLE-silent. A complete metal change from Ag12 to Au12 in the achiral core section of S2-@M12@S8 engenders isomorphous heterometal R/S-Au12Ag32, which activates CPLE. We further quantify the contributions of achiral and chiral sections and for the first time unveil that heterometal bonding (Au12-Ag32) at the linkage varies the delocalization of orbitals and proportion of achiral and chiral section in electron transition-involved orbitals, thus activating CPLE. Based on these unique atomically precise homochiral metal clusters, our work provides a new insight into the contributions of achiral and chiral sections to the origin of chiroptical response of chiral metal clusters, paving the way to advance the development of CPLE nanoparticles.

Soluble Hybrid Ionic Semiconductor and Its Photovoltaic Effect in Solution.

Semiconductor materials were adopted in their solid states for photovoltaic applications owing to their nonsolubility and/or breaking of the photogenerated carrier transfer pathway in solution. The liquid-state photovoltaic device fills in a gap between currently prevailing full-solid-state and solid-liquid-state solar cells; however, reports on the photovoltaic effect from realistic semiconductor solution are absent so far. Herein, we report a hybrid inorganic-organic ionic semiconductor [Ni(Phen)3][V14O34Cl]Cl (Phen = 1,10-phenanthroline) and observe its photovoltaic effect in ionic liquid solution. This photovoltaic effect arises as a result of charge transfer between the coordination cation and inorganic polyoxovanadate in solution under illumination and subsequent transfer to electrodes. The liquid-state photovoltaic device (cell configuration: carbon cloth||[Ni(Phen)3][V14O34Cl]Cl in ionic liquid||Al foam) yields an open-circuit voltage of ca. 1.199 V and a photocurrent density of 3.268 mA cm-2 upon illumination using an air mass of 1.5 (100 mW cm-2) at 80 °C with a fill factor of 42.48% and an efficiency of 1.665%. This novel type of hybrid ionic semiconductor possesses great structural tunability for an optimized photovoltaic performance.

Multiple-cation wide-bandgap perovskite solar cells grown using cesium formate as the Cs precursor with high efficiency under sunlight and indoor illumination.

Owing to the advantages of adjustable bandgap, low-cost fabrication and superior photovoltaic performance, wide-bandgap (WBG) perovskite solar cells (PSCs) are considered as the promising top-cell for multi-junction solar cells. At the same time, WBG PSCs have also shown great potential for indoor photovoltaic applications. To further improve the performance of WBG PSCs, in this work, we fabricated efficient WBG PSCs via introducing cesium formate (CsFa) as the Cs precursor. Due to the HCOO·Pb+ and HCOOH·Cs+ complex formation and HCOOH volatilization accompanying the crystallization process, the crystallization of the perovskite using the CsFa precursor (CsFa-perovskite) is promoted. Compared to the perovskite prepared using the CsBr precursor (CsBr-perovskite), the WBG CsFa-perovskite shows better perovskite crystallization, reduced trap-state density, and better phase stability under light illumination. Finally, the 1.63 eV WBG PSCs based on the CsFa-perovskite achieve a significant PCE of 20.01% under one sun illumination (AM 1.5G, 100 mW cm-2), which is higher than that of PSCs based on the CsBr-perovskite (18.27%). Moreover, the PCE of CsFa-perovskite PSCs also under indoor warm-white 2700 K LED light illumination (1000 lux) is as high as 38.52%. Our results demonstrate that CsFa as the Cs precursor is a promising candidate to promote the device performance of WBG PSCs.

Surgical Strategies for Pre- and Minimally Invasive Lung Adenocarcinoma 3.0: Lessons Learned From the Optimal Timing of Surgical Intervention.

We discuss the optimal timing of surgery for lung cancer, and propose 3 surgical strategies for pre- and minimally invasive lung adenocarcinoma to avoid "overdiagnosis" and "overtreatment." Benign disease should not be treated as malignancy, pre- and minimally invasive disease should not be treated as invasive disease, and indolent malignancy should not be treated as aggressive malignancy.

Dissecting the single-cell transcriptome network in patients with esophageal squamous cell carcinoma receiving operative paclitaxel plus platinum chemotherapy.

Esophageal squamous cell carcinoma (ESCC) accounts for 90% of all cases of esophageal cancers worldwide. Although neoadjuvant chemotherapy (NACT-ESCC) improves the survival of ESCC patients, the five-year survival rate of these patients is dismal. The tumor microenvironment (TME) and tumor heterogeneity decrease the efficacy of ESCC therapy. In our study, 113,581 cells obtained from five ESCC patients who underwent surgery alone (SA-ESCC) and five patients who underwent preoperative paclitaxel plus platinum chemotherapy (NACT-ESCC), were used for scRNA-seq analysis to explore molecular and cellular reprogramming patterns. The results showed samples from NACT-ESCC patients exhibited the characteristics of malignant cells and TME unlike samples from SA-ESCC patients. Cancer cells from NACT-ESCC samples were mainly at the 'intermediate transient stage'. Stromal cell dynamics showed molecular and functional shifts that formed the immune-activation microenvironment. APOE, APOC1, and SPP1 were highly expressed in tumor-associated macrophages resulting in anti-inflammatory macrophage phenotypes. Levels of CD8+ T cells between SA-ESCC and NACT-ESCC tissues were significantly different. Immune checkpoints analysis revealed that LAG3 is a potential immunotherapeutic target for both NACT-ESCC and SA-ESCC patients. Cell-cell interactions analysis showed the complex cell-cell communication networks in the TME. In summary, our findings elucidate on the molecular and cellular reprogramming of NACT-ESCC and ESCC patients. These findings provide information on the potential diagnostic and therapeutic targets for ESCC patients.

Is flexible bronchoscopy necessary in the preoperative workup of patients with peripheral cT1N0 subsolid lung cancer? -a prospective multi-center cohort study.

BACKGROUND: Necessity of flexible bronchoscopy (FB) examination as a routine preoperative work-up for peripheral clinical T1N0 subsolid lung cancer was unknown. METHODS: This was a prospective, multi-center clinical trial (NCT03591445). Patients with peripheral GGO nodules (GGNs) who were candidates for surgical resection were enrolled. FB examination was performed preoperatively. Surgical plan could be changed if any aberrant histologic and anatomic findings were detected by FB examination. Primary endpoint was the rate that surgical plan was changed by positive FB findings. Secondary endpoints were rate of positive FB findings and rate of procedural complications. RESULTS: Six hundred and fifteen patients with peripheral subsolid nodules detected by thoracic CT were enrolled. There were 187 (30.4%) male and 428 (69.6%) female patients, mean age was 54.85±10.41 y (range, 26-78). 262 (42.6%) patients had pure GGNs and 353 (57.4%) patients had part-solid nodules. Mean size of nodules was 13.87±6.37 mm (range, 5-30). FB examinations confirmed one (0.16%) adenocarcinoma, seven (1.14%) bronchial variations, one (0.16%) segmental bronchostenosis, one (0.16%) segmental bronchial occlusion and one (0.16%) bronchial inflammation. No complications of FB examinations occurred. 568 (92.35%) thoracoscopic and 47 (7.65%) open surgeries were performed. No established surgical plan was changed by positive FB findings. Final pathologies revealed 26 (4.2%) adenocarcinoma in situ (AIS), 240 (39%) minimal invasive adenocarcinomas (MIAs), 343 (55.8%) invasive adenocarcinomas (IADs), one (0.2%) adenosquamous cell carcinoma, one (0.2%) squamous cell carcinoma, two (0.3%) atypical adenoid hyperplasia and two (0.3%) inflammations. CONCLUSIONS: FB examination was unnecessary in the preoperative assessment of peripheral clinical T1N0 subsolid lung cancer.