Insights into cryptic speciation of quillworts in China.

Cryptic species are commonly misidentified because of high morphological similarities to other species. One group of plants that may harbor large numbers of cryptic species is the quillworts (Isoëtes spp.), an ancient aquatic plant lineage. Although over 350 species of Isoëtes have been reported globally, only ten species have been recorded in China. The aim of this study is to better understand Isoëtes species diversity in China. For this purpose, we systematically explored the phylogeny and evolution of Isoëtes using complete chloroplast genome (plastome) data, spore morphology, chromosome number, genetic structure, and haplotypes of almost all Chinese Isoëtes populations. We identified three ploidy levels of Isoëtes in China-diploid (2n = 22), tetraploid (2n = 44), and hexaploid (2n = 66). We also found four megaspore and microspore ornamentation types in diploids, six in tetraploids, and three in hexaploids. Phylogenetic analyses confirmed that I. hypsophila as the ancestral group of the genus and revealed that Isoëtes diploids, tetraploids, and hexaploids do not form monophyletic clades. Most individual species possess a single genetic structure; however, several samples have conflicting positions on the phylogenetic tree based on SNPs and the tree based on plastome data. All 36 samples shared 22 haplotypes. Divergence time analysis showed that I. hypsophila diverged in the early Eocene (∼48.05 Ma), and most other Isoëtes species diverged 3-20 Ma. Additionally, different species of Isoëtes were found to inhabit different water systems and environments along the Yangtze River. These findings provide new insights into the relationships among Isoëtes species in China, where highly similar morphologic populations may harbor many cryptic species.

Changes of DNA methylation of Isoetes sinensis under Pb and Cd stress.

To investigate the molecular response of ancient plants to heavy metal stress and to explore the feature of DNA methylation in endangered plants after exposure to heavy metals, the Isoetes sinensis, an endangered plant, was stressed with three different concentrations of two heavy metals lead (Pb) and cadmium (Cd), respectively. Then the degrees and the patterns of DNA methylation in the leaves were measured on the 14th day using Methylation Sensitive Amplified Polymorphism (MSAP) technique. The results showed that the DNA methylated profile of I. sinensis was affected by Pb and Cd stress. There was no significant difference in the amount of DNA methylation among control check (CK), Pb stress group, and Cd stress group (CK 46.96%, Pb 48.23%, and Cd 48.1%). However, full-methylation level of Pb stress group (28.34%) and Cd stress group (20.25%) was lower than control (33.91%), in contrast, hemi-methylation level Pb stress group (19.89%) and Cd stress group (27.85%) were higher than control (13.04%). The change of patterns from no methylation or hemi-methylation of internal and external cytosines into full-methylation of internal and external cytosines accounted for a large proportion in enhanced methylation aspects. The full-methylation into no methylation or hemi- or full-methylation of internal and external cytosines occupied most of demethylation. The proportion of DNA methylation (including hypermethylation) by both Pb and Cd stresses is nearly equal (39.04% and 39.71%), but the proportion of DNA demethylation by Cd is higher than that by Pb (46.86% than 33.92%).

The identity of Hypolepis robusta, as a new synonym of Hypolepis alpina (Dennstaedtiaceae), based on morphology and DNA barcoding and the new distribution.

Based on field observations and examinations of herbarium specimens (including type material), consulting the original literature and molecular phylogenetic analysis of the rbcL and trnL-F sequences, it is concluded that Hypolepis robusta is conspecific with Hypolepis alpina and is here formally treated as a synonym of it. Additionally H. alpina is reported with new distribution records in Guangdong, Guangxi and the Hainan Island of China, respectively.

Expert consensus on image-guided radiofrequency ablation of pulmonary tumors: 2018 edition.

Lung cancer ranks first in incidence and mortality in China. Surgery is the primary method to cure cancer, but only 20-30% of patients are eligible for curative resection. In recent years, in addition to surgery, other local therapies have been developed for patients with numerous localized primary and metastatic pulmonary tumors, including stereotactic body radiation therapy and thermal ablative therapies through percutaneously inserted applicators. Percutaneous thermal ablation of pulmonary tumors is minimally invasive, conformal, repeatable, feasible, cheap, has a shorter recovery time, and offers reduced morbidity and mortality. Radiofrequency ablation (RFA), the most commonly used thermal ablation technique, has a reported 80-90% rate of complete ablation, with the best results obtained in tumors < 3 cm in diameter. Because the clinical efficacy of RFA of pulmonary tumors has not yet been determined, this clinical guideline describes the techniques used in the treatment of localized primary and metastatic pulmonary tumors in nonsurgical candidates, including mechanism of action, devices, indications, techniques, potential complications, clinical outcomes, post-ablation surveillance, and use in combination with other therapies. In the future, the role of RFA in the treatment of localized pulmonary tumors should ultimately be determined by evidence from prospective randomized controlled trials comparing sublobar resection or stereotactic body radiation therapy.

Chinese expert consensus workshop report: Guidelines for thermal ablation of primary and metastatic lung tumors.

Although surgical resection is the primary means of curing both primary and metastatic lung cancers, about 80% of lung cancers cannot be removed by surgery. As most patients with unresectable lung cancer receive only limited benefits from traditional radiotherapy and chemotherapy, many new local treatment methods have emerged, including local ablation therapy. The Minimally Invasive and Comprehensive Treatment of Lung Cancer Branch, Professional Committee of Minimally Invasive Treatment of Cancer of the Chinese Anti-Cancer Association has organized multidisciplinary experts to develop guidelines for this treatment modality. These guidelines aim at standardizing thermal ablation procedures and criteria for selecting treatment candidates and assessing outcomes; and for preventing and managing post-ablation complications.

[A comparative study of complete video-assisted thoracoscopic lobectomy and video-assisted mini-thoracotomy in treatment of lung cancer].

OBJECTIVE: To explore the clinical application value of complete video-assisted thoracoscopic (cVATS) lobectomy in the mini-invasive treatment of lung cancer. METHODS: 90 patients with non-small cell lung cancer (NSCLC) who had undergone lobectomy were reviewed. According to surgical approach, complete video-assisted thoracoscopic lobectomy group (cVATS, n = 47) and video-assisted mini-thoracotomy group (VAMT, n = 43) were studied. Numbers of dissected lymph nodes, operation duration, volumes of intraoperative bleeding, duration of postoperative catheter drainage, length of postoperative hospital stay, incidence rates of postoperative complications, postoperative pain scores of patients were compared between the two groups retrospectively. RESULTS: There were no significant differences in numbers of dissected lymph nodes, operation duration, bleeding during operation, incidence rates of postoperative complication between the two groups (P > 0.05). Duration of postoperative catheter drainage and length of postoperative hospital stay of patients in cVATS group were shorter than those in VAMT group (P < 0.05). Pain scores of patients in cVATS group were lower than those at the same time in VAMT group (P < 0.05). CONCLUSION: Complete video-assisted thoracoscopic lobectomy is safe and effective surgical strategy for lung cancer patients with advantage of rapid recovery.

[Surgical treatment of primary thymoma].

OBJECTIVE: To summarize the clinical and pathologic features of thymoma and assess surgical treatment thereof. METHODS: The clinical data of 66 thymoma patients, 35 males and 31 females, aged 40.8 (30 approximately 59), who underwent surgical treatment in the past 20 years, were analyzed. By Masaoka staging system, underwent extensive or radical or palliative operation, most commonly performed through a median sternotomy and frequently requires en-bloc resection of one or more adjacent structures. RESULTS: Fourteen of the 66 patients had associated myasthenia gravis (MG). The most common symptoms included chest pain, MG, cough, and dyspnea; only 11 of the 66 (16.7%) patients had no symptom. Masaoka staging revealed stage I in 29 patients (43.9%), stage II in 16 (24.2%), stage III in 19 (28.8%), and stage IV in 2 (3.0%). Fourteen of the 66 patients underwent radical resection, resection of the whole thymus and thymoma, 40 underwent simple resection of thymus, 5 underwent palliative resection of thymoma, and 6 underwent thymectomy exploration. Recurrence of tumor was observed in 4 patients. Postoperative radiotherapy and chemotherapy were performed 24 h after the operation, mainly in the cases of invasive or metastatic thymoma. One patient died within 30 days after the operation. CONCLUSIONS: Resection and postoperative radiotherapy or chemotherapy are necessary in treatment of thymoma, particularly complete thymectomy.

[Clinical value of computed tomography and fluorine-18 fluorodeoxyglucose positron remission tomography in diagnosis of mediastinal metastasis of non small cell lung cancer].

OBJECTIVE: To compare the clinical values of computed tomography (CT) and fluorine-18 fluorodeoxyglucose positron remission tomography (FDG-PET) in diagnosis of mediastinal metastasis of non-small cell lung cancer (NSCLC). METHODS: Sixty patients with respectable NSCLC underwent CT and FDG-PET with an interval of 2 weeks and then underwent thoracotomy for clearance of the lymph nodes or biopsy of the mediastinal lymph nodes via mediastinoscopy. The specimens of mediastinal lymph node underwent HE staining and PCNA/Ki67 immunohistochemical staining. The sensitivity, specificity, accuracy, positive prediction value, and negative prediction value in diagnosis of metastasis of mediastinal lymph nodes of these 2 procedures were compared. RESULTS: The sensitivity, specificity, accuracy, positive prediction value, and negative prediction value in diagnosis of metastasis of mediastinal lymph nodes were 92.3%, 87.5%, 91.2%, 96.0%, and 77.7% respectively for FDG-PET, and were 76.9%, 50.0%, 70.6%, 83.3%, and 40.0% respectively for CT. The sensitivity rate was 98% for CT plus FDG-PET. CONCLUSION: PET is superior to CT in diagnosis of metastasis of NSCLC to mediastinal lymph nodes. PET + CT significantly increases the sensitivity in diagnosis.

[The value of postoperative arterial infusion chemotherapy in patients with T3 esophageal squamous carcinoma after radical surgery].

OBJECTIVE: To studying the porgnostic factors after curative esophagetomy for the thoracic segment T3 esophageal after radical surgery. METHODS: 190 patients suffering from T3 squamous carcinoma of lower thoracic esophagus who underwent radical surgery from January 1990 to January 1999, 158 males and 32 females, aged 62.98 (40 approximately 81), were divided into 2 groups: 108 patients (experimental group, T3N0M0 56 cases and T3N1M0 52 cases) underwent surgery and arterial infusion (cisplatin 80 mg/m(2) and fluorouracil (800 mg/m(2)) with or without epirubicin since 3 approximately 4 weeks postoperatively, the interval of each periods is 4 - 6 weeks. and the other 82 patients (T3N0M0 48 cases and T3N1M0 34 cases) underwent surgery only. Fifty-six out of the 108 cases in the experimental group (T3N0M0 26 cases and T3N1M0 30 cases) underwent 3 periods of chemotherapy for less than 3 periods of chemotherapy with an interval between 2 periods of 4 approximately 6 weeks, and the other 52 patients (T3N0M0 30 cases and T3N1M0 22 cases) underwent chemotherapy for 3 periods or over. All cases were followed up for more than 5 years. Kaplan-Meier survival curve was used to analyze the survival rate. Cox regression model was used to analyze the influencing factors of prognosis. RESULTS: There was no significant difference in the overall long-term survival rate between the experimental group and control group, however, the survival rate of those receiving 3 periods of chemotherapy and over was significantly higher than those receiving less than 3 periods of chemotherapy Lymph node metastatic status was an important factor in prognosis of esophageal squamous carcinoma. CONCLUSION: Without severe side effects, postoperative chemotherapy by transcatheter arterial infusion prolongs the survival rate of the patients with esophageal squamous carcinoma who have been previously treated by radical surgery.