The objective of this study was to evaluate the clinical significance of carbohydrate antigen (CA) 153 and its correlation with Krebs von den Lungen-6 (KL-6) in the prediction and determination of the severity of interstitial lung disease (ILD) in rheumatoid arthritis (RA) patients. Data was collected retrospectively on a cohort of 357 RA patients who were admitted to our hospital from January 2018 to December 2020. The classification of patients into subgroups was based on high-resolution computed tomography (HRCT) of the chest, resulting in 135 patients with RA but no ILD, 107 patients with RA and indeterminate ILD, 91 patients with RA and mild ILD, and 24 patients with RA and advanced ILD. The levels of CA153 and KL-6 were determined by chemiluminescence analysis. The serum levels of CA153 were found to be significantly higher in both the RA-mild ILD group and the RA-advanced ILD group compared to the RA-no ILD group (8.00 vs. 6.40, q = 0.039; 20.30 vs. 6.40, q < 0.001). Multivariate analysis demonstrated that CA153 was an independent risk factor for RA-ILD (RA-mild ILD + RA-advanced ILD) [odds ratio (OR) = 1.124, 95

Accurate differentiation of the histologic invasiveness of early-stage lung adenocarcinoma is crucial for determining surgical strategies. This study aimed to investigate the potential of [68Ga]Ga-FAPI-46 PET/CT in assessing the invasiveness of early lung adenocarcinoma presenting as ground-glass nodules (GGNs) and identifying imaging features with strong predictive potential. This prospective study (NCT04588064) was conducted between July 2020 and July 2022, focusing on GGNs that were confirmed postoperatively to be either invasive adenocarcinoma (IAC), minimally invasive adenocarcinoma (MIA), or precursor glandular lesions (PGL). A total of 45 patients with 53 pulmonary GGNs were included in the study: 19 patients with GGNs associated with PGL-MIA and 34 with IAC. Lung nodules were segmented using the Segment Anything Model in Medical Images (MedSAM) and the PET Tumor Segmentation Extension. Clinical characteristics, along with conventional and high-throughput radiomics features from High-resolution CT (HRCT) and PET scans, were analysed. The predictive performance of these features in differentiating between PGL or MIA (PGL-MIA) and IAC was assessed using 5-fold cross-validation across six machine learning algorithms. Model validation was performed on an independent external test set (n = 11). The Chi-squared, Fisher’s exact, and DeLong tests were employed to compare the performance of the models. The maximum standardised uptake value (SUVmax) derived from [68Ga]Ga-FAPI-46 PET was identified as an independent predictor of IAC. A cut-off value of 1.82 yielded a sensitivity of 94 https://clinicaltrials.gov/study/NCT04588064 .

Pulmonary Ground-Glass Opacity (GGO) on Computed Tomography (CT) is considered a diagnostic feature of lung adenocarcinoma. However, a significant radiological predictive sign remain controversial

Introduction:Preoperative computed tomography (CT)-guided localization can shorten the time of video-assisted thoracoscopic surgery (VATS) and accurately aid in pulmonary nodule removal.Aim:To discuss the application value and safety of 2 kinds of breast localization needles and anchor localization needles in clinical practice for pulmonary nodules under CT guidance before VATS.Material and methods:We retrospectively studied 215 patients with 247 pulmonary nodules, who underwent CT-guided pulmonary nodule location before VATS. The 2 kinds of localization needles were randomly used, and we collected and analysed the clinical data.Results:We used breast and anchor localization needles in 27.9% and 72.1% of cases, respectively. Differences were observed in puncture localization time, detachment rate, and visual analogue scale (VAS). The detachment rate (0%) and positioning time (median: 12 min) were less in the anchor than in the breast localization needle group (8.7% and median: 13 min, respectively). The median VAS was approximately 2 and 5 in the anchor and breast localization needle groups, respectively. Surgical pathology revealed that 155 (62.8%) pulmonary nodules were malignant while 92 (37.2%) were benign. The primary distinction in surgical procedures is the higher proportion of segmental resections in the middle and inner band group (19.3%) compared to the periphery band group (4.2%).Conclusions:Unlike breast localization needles, anchor localization needles can reduce pain and discomfort after positioning, and they are not easy to decouple. These 2 needles are safe for CT-guided localization, which can shorten the time of VATS and accurately aid in pulmonary nodule removal.

Background Ovarian-tumor (OTU) domain-containing protein 6B (OTUD6B), one of newly identified OTU deubiquitylating enzyme families, is proved to be associated with tumor progression. However, whether it plays a key role in pan-cancer still remains unknown. Methods The profiles of OTUD6B expression in multiple cancers were analyzed using The Cancer Genome Atlas (TCGA) database. Information of protein expression was performed based on the HPA, GeneCards, and String databases. K-M plotter and survival data analysis were used to analyze the prognostic value of OTUD6B expression, including overall survival (OS), disease-specific survival (DSS), disease-free interval (DFI), and progression-free interval (PFI). R package “clusterProfiler” was used for enrichment analysis of OTUD6B. Furthermore, we analyzed the correlation between the expression of OTUD6B, immune infiltration, and immune-related genes. Additionally, we preliminarily validated its tumorigenic effect in lung cancer cell lines. Findings OTUD6B expression was upregulated in most cancers, such as COAD, CHOL, and LUAD, and predicted poor prognosis in most cancers in TCGA. Results showed that OTUD6B expression was positively correlated with memory CD4+ T cells, Th1 CD4+ T cells, and CD8+ T cells. In terms of the immune-related genes, OTUD6B was found to be associated with most types of genes, such as immunostimulatory genes KDR, TGFBR1, and IL-10. Moreover, for most types of tumors, the immune score was found to be negatively correlated with OTUD6B expression. In addition, lung cancer cell lines with OTUD6B knockdown significantly inhibited proliferation and invasion ability of lung cancer cells. Conclusions The study indicated that OTUD6B is an oncogene and may serve as a new potential biomarker in various tumors. OTUD6B may play a part in TIME, which could be applied as a new target for cancer therapy.

目的 分析肺结节结构化电子病历是否有助于住院医师规范化培训学员(住培学员)掌握肺结节患者的门诊和住院管理能力.方法 本研究纳入2018年1月-2021年1月在厦门大学附属第一医院外科住院医生规范化培训基地接受培训的120名学员,其中男94人、女26人,年龄22～31(26.45±2.81)岁.随机分为两组,分别使用我科设计的肺结节结构化电子病历(结构化组)和外科通用非结构化电子病历(非结构化组),分析比较两组学员在住院病历撰写时间、首次病程记录完成时间、病程记录的病历质量、开具入院医嘱的准确率、进行教学查房的质量、患者满意度等方面的差异.结果 (1)结构化组住培学员住院病历撰写时间显著短于非结构化组[(53.61±8.12)min vs.(84.25±16.09)min,P＜0.010];同样,结构化组首次病程记录完成时间短于非结构化组,且差异有统计学意义[(13.20±5.43)min vs.(27.51±8.62)min,P＜0.010].(2)结构化组学员教学查房质量评分总体显著高于非结构化组,且差异有统计学意义[(84.21±15.61)分vs.(70.91±12.28)分,P＜0.010].(3)结构化组学员病历书写质量评分显著高于非结构化组,且差异有统计学意义[(80.25±9.22)分vs.(74.22±5.40)分,P＜0.010].结论 肺结节结构化电子病历在外科住院医师规范化培训中能有效提高培训效果,提高学员处理肺结节的临床业务能力,提高学员采集关键临床数据的完整性和准确性,改善医患关系.

目的 通过肺结节交互印证式诊断,提高术前影像诊断的准确率,选择合适的手术时机,指导肺小结节的随访时间.方法 回顾性分析单中心2016年7月至2019年10月厦门大学附属第一医院胸外科1 368例肺结节手术患者的临床资料,男531例、女837例,年龄44(21～67)岁.选择肺结节直径≤2 cm,术前行多学科会诊,详细阅读胸部CT,术中切开病灶剖面进行分析,快速病理诊断肺结节性质,术后常规行病理诊断.随后将肺结节影像特征、术中剖面特征与病理结果一一对照,通过两两对应,交互印证,把肺结节的影像病理及病变切面表现为一个动态变化的过程.结果 在1 368例肺小结节患者中,影像学表现为纯磨玻璃样结节的有376例(27.5％),混合性磨玻璃样结节共有729例(53.3％),实性结节共有263例(19.2％).在纯磨玻璃样结节患者中,原位腺癌(adenocarcinoma in situ,AIS)占比最高,为156例,微浸润性腺癌(microinvasive adenocarcinoma,MIA)和不典型腺瘤样增生(atypical adenomatous hyperplasia,AAH)比例相当,分别为90例和85例,其它良性肿瘤共20例.在混合性磨玻璃样结节中,浸润性腺癌(invasive adenocarcinoma,IA)共495例,其次是MIA 207例;且在实性结节中,病理结果主要为IA和其它良性肿瘤,分别为213例和50例,实性结节病理无AAH、AIS及MIA.结论 肺结节交互印证式诊断可以提高术前诊断的准确率,对选择手术时机、随访时间的判断具有重要意义.

Objective:To investigate the difference of HRCT imaging features between COVID-19 and the ground-glass opacity(GGO) lesion of early-stage lung carcinoma, standardize the diagnosis and treatment process of ground-glass opacity(GGO) degeneration during the epidemic.Methods:A total of 34 patients with diagnosed COVID-19 who confirmed by positive results of the new coronavirus nucleic acid test were collected as observation group 40 patients with pathologically diagnosed early-stage lung carcinoma whose preoperative HRCT examination showed pure ground glass lesions and received surgical intervention were recruited from the Department of Thoracic Surgery (The First Affiliated Hospital of Xiamen University) from January 2018 to December 2019 as the control group. The HRCT imaging features of these two groups of patients were compared and statistically analyzed.Results:The HRCT imaging features of the new type of COVID-19 showed significant difference by characteristics of multiple lesions, lesion rapid variation within 3 days, reticular pattern, vacuolar sign and clear boundary compared to the GGO lesion of early-stage lung carcinoma( P<0.05). The chinical and imaging characteristic the sex, age, with pleural effusion or not and the lesion location showed no significant difference between these 2 groups ( P>0.05). Conclusion:Contrast with inert early lung carcinoma lesions, COVID-19 disease developed rapidly. Imaging dynamic examination can provide evidences to distinguish Novel Coronavirus Pneumonia and early-stage lung carcinoma.

目的 探讨全胸腔镜肺叶切除术中应用超细胸腔引流管和常规粗引流管对引流效果,患者疼痛程度及引流相关并发症的影响.方法 选取2017年1月至2018年9月行全胸腔镜肺癌根治术的156例患者,随机分为A组(超细胸管组)和B组(常规粗胸管组)各78例,比较两组术后引流时间、总引流量、术后住院时间、术后疼痛评分及引流相关并发症发生率等情况.结果 A组术后引流时间、总引流量、引流相关并发症显著少于B组(P＜0.05),术后第3、4天疼痛评分A组显著低于B组(P＜0.05),两组住院时间、术后第1、3、5天疼痛评分差异无统计学意义(P＞0.05).结论 全胸腔镜肺叶切除术后应用超细胸腔引流管可缩短引流时间,减轻术后疼痛,降低引流相关并发症的发生,且切口愈合美观,是效果确切满意的引流方式.

目的:探讨鸦胆子油乳在体外对肺腺癌细胞SPA-A1的抑制作用。方法:本研究通过鸦胆子油乳处理肺腺癌细胞（SPA-A1）,采用MTT法观察其对细胞生长的抑制效应;DAPI染色观察肺腺癌细胞SPA-A1凋亡的形态学改变;流式细胞术测定细胞凋亡率及分析细胞周期变化。结果:鸦胆子油乳对肺腺癌细胞SPA-A1的抑制呈剂量和时间依赖性;鸦胆子油乳作用后SPA-A1细胞呈凋亡形态学改变;不同浓度的鸦胆子油乳作用SPA-A1细胞后,可以有效地引起细胞凋亡,且具有明显的剂量依赖性;并可阻滞SPA-A1细胞于G0/G1期。结论:鸦胆子油乳可抑制肺腺癌SPA-A1细胞增殖,诱导肺腺癌SPA-A1细胞凋亡,并使肺腺癌SPA-A1细胞阻滞于G0/G1期。

Objective To discuss the safety and efficacy of the 3D mode video-assisted thoracoscopic surgery (3D-VATS)for mediastinal tumor. Methods Data were collected from 62 patients with mediastinal tumor treated with 3D-VATS from July 2013 to July 2015 in our department.The observation port and the operation port were determined according to the tumor location,which could be swapped during the operation based on surgical situation.If the tumor diameter was greater than 5 cm,or close to great blood vessel,or with the surrounding adhesion difficult to expose,small incision video-assisted minithoracotomy (VAMT)was employed. Results The 3D-VATS was successfully completed in 58 cases.VAMT was conducted in 3 cases because of tumor diameter of 6 cm. Conversion to open surgery was required in 1 case due to tumor invasion to the left unknown vein.Intraoperative injury to the phrenic nerve leading to diaphragm elevation happened in 2 cases,which recovered 3 months after operation.Pulmonary atelectasis was seen in 2 cases, which were given anti-inflammatory, atomization, and expectoration until relief. No death occurred intraoperatively, postoperatively or 30 days after surgery.Postoperative pathology showed 31 cases of thymoma,16 cases of thymic hyperplasia,5 cases of thymic carcinoma,1 case of bronchogenic cyst,1 case of thymic cyst,2 cases of proliferation of lymphocytes,3 cases of teratoma, 2 cases of neurogenic tumor,and 1 case of pleural lipoma.All the 62 cases were followed up for 1 -24 months,with a median follow-up time of 12 months.No recurrence was seen in all the benign cases,while 1 case of thymic carcinoma recurred. Conclusion Treatment of mediastinal tumor with 3D-VATS is a new choice,bearing safe and feasible clinical effects.

Objective To evaluate the effects of surgical treatment for solitary pulmonary nodules under thoracoscopic 3D mode(3D-VATS). Methods A total of 50 cases of solitary pulmonary nodules from March 2013 to March 2014 were retrospectively analyzed.Intraoperative wedge pulmonary resection with 3D-VATS was utilized.According to intraoperative pathological findings , lobectomy plus lymph node dissection was given or not .Intraoperative time (minus fast freezing time), drainage volume for 24 h, total drainage volume , drainage tube removal time , number of lymph node dissected , and postoperative complications were recorded . Results Under 3D-VATS mode, 50 cases of solitary pulmonary nodules were treated with wedge resection , including 23 cases of malignant pathology receiving radical resection , which was smoothly . The radical resection time ( lung lobectomy plus lymphadenectomy) was (62 ±12) min, the bleeding volume was (35 ±5) ml, the lymphadenectomy number was 19 ±3, the drainage volume for 24 h was (120 ±20) ml, the postoperative chest tube removal time was (4 ±1) days, and the postoperative hospital stay was (7 ±2) days.Postoperative complications occurred in 3 cases, including 2 cases of pneumonia and 1 case of paroxysmal atrial fibrillation.No perioperative deaths were observed .All the cases were followed up for 2-12 months, with an average of 6.3 months. Brain metastases was found in 1 case at the third postoperative month and recurrence of lung cancer was noted in 1 case at the fifth postoperative month . Conclusion Thoracoscopic 3D mode treatment for solitary pulmonary nodules is a new , safe, and feasible alternative and should be widely applied .

Objective To investigate clinical feasibility and efficacy of combined use of thoracoscopy and laparoscopy in total laryngectomy for cervical esophageal carcinoma . Methods Clinical data of 33 patients with cervical esophageal carcinoma undergoing surgical treatment in our department from January 2009 to July 2014 were analyzed retrospectively .The esophagus was separated under thoracoscopy .And laparoscopic gastroplasty , total laryngectomy , tracheal permanent colostomy , and gastric pharyngeal anastomosis were performed. Results The thoracoscopic operation time was 40 -66 min ( mean, 53 min), the laparoscopic operation time was 35-51 min (mean, 44 min), and the cervical operation time was 128-150 min (mean, 139 min).The blood loss was 130 -270 ml (mean, 150 ml).The postoperative hospital stay was 8 -14 d (mean, 12 d).Pathological examinations showed squamous cell carcinoma in all the cases , including 2 cases of highly differentiated carcinoma , 19 cases of moderately differentiated carcinoma , 7 cases of moderately or lowly differentiated carcinoma , and 5 cases of lowly differentiated carcinoma .No residual cancer was found at cutting edges pathologically .Among the 33 cases, lymph node metastasis was found in 31 cases. Complications included 2 cases of anastomotic fistula , 3 cases of recurrent laryngeal nerve injury , 6 cases of pulmonary infection , 2 cases of delayed gastric emptying , and 1 case of anastomotic stenosis .There was no death .All the patients were followed up for 1 months to 5 years.The survival rates at 1, 3, and 5 postoperative year were 87.9%, 54.5%, and 45.5%, respectively. Conclusions Cervical esophageal carcinoma should be surgically treated actively .Gastric pharyngeal anastomosis is an ideal option for the repair of cervical esophageal cancer resection .

Objective To investigate the feasibility of Storz three dimensional video-assisted thoracoscopic surgery (3D-VATS) for the treatment of pulmonary disease. Methods In July 2013, under 3D video-assisted thoracoscope (Storz), lobectomy plus systematic lymphadenectomy was performed on 2 cases and local resection was performed on 2 cases respectively .The seventh intercostal space along the midaxillary line was selected as observation port of the thoracoscope ; an incision of 2-3 cm in length made at the third or fourth intercostal space along the anterior axillary line was used for main operating port and a 2 cm incision at the eighth or ninth intercostal space along the posterior axillary line was used for the first assisted operating port .Wearing 3D polarization glasses , we performed local excision or lobectomy combined with systematic lymphadenectomy on the 3D effect operation screen. Results Four operations were accomplished successfully , without conversion to open surgery .No complications or death occurred.The operative time was 36, 38, 72 and 90 min, respectively; the blood loss was 5, 10, 35 and 80 ml, respectively and postoperative hospital stay was 3, 3, 5 and 7 d, respectively.No complications were observed during the follow-up of 2 months. Conclusion Compared with VATS, 3D-VATS is safe and feasible for pulmonary disease with a lifelike view and improved flexibility .

目的 比较多西他赛单药、顺铂单药以及两药联合三种方案治疗晚期非小细胞肺癌(NSCLC)的疗效.方法 104例经病理确诊无手术指征的晚期NSCLC患者.多西他赛组给予艾素75 mg/m2,顺铂组给予顺铂100 mg/m2,联合组给予艾素75 mg/m2加顺铂80 mg/m2.比较三个化疗方案反应率、中位生存期、1 a生存率.结果 联合组的反应率和中位生存期明显高于其他两组.结论 多西他赛联合顺铂有较好疗效,单用顺铂不能延长患者的生存期.

BACKGROUND AND OBJECTIVE:GRP75, a member of HSPs which is overexpressed in some resistant cancer cells, is a molecular chaperone mainly located in mitochondrial membrane. The aim of this study is to investigate the role of GRP75 on the resistant mechanisms of cancer cells by downregulating GRP75 expreesion via RNAi approach.METHODS:Cisplatin-resistant cell A549/CDDP was established from their parental human lung adenocarcinoma cell line A549 by combining gradually increasing concentrations of cisplatin with high dosage impact. The shRNA for GRP75 was transfected into A549 and A549/CDDP cells by lentivirus. Western blot and methyl thiazolyl tetrazolium (MTT) assay were applied to detect the influence of silencing GRP75 expression on sensitivity of the cells to cisplatin.RESULTS:The infection rate of six groups were all over 90%. After infection, the level of expression of GRP75 in both A549 and A549/CDDP were down-regulated (P < 0.05); the level of expression of p53 in A549/CDDP was up-regulated (P < 0.05) and the level of expression of bcl-2 of A549/CDDP was down-regulated (P < 0.05). The resistance index of A549/CDDP before and after infection were 21.52 and 4.14 respectively.CONCLUSIONS:Cisplatin resistance of lung cancer cells is associated with overexpression of GRP75 gene, which could regulate the expressions of p53 and bcl-2.

目的 比较肠内(EN)与全肠外营养(TPN)支持对恶性胸水患者机体免疫功能的影响,探讨恶性胸水患者合理的营养支持方式.方法 采用前瞻性对比研究,将45例恶性胸水患者随机分为EN组和TPN组,分别给予EN和TPN支持治疗.于治疗开始之前检查所有患者的外周血IgA、IgG、IgM、淋巴细胞总数(TLC)及T 细胞亚群CD3+、CD4+百分率和CD4+/CD8+比值 ,于治疗两周后复查上述指标.结果 EN组IgG、TLC、CD4+T细胞以及CD4+/CD8+比值在营养支持前后及与TPN组相比获得明显改善(P<0.05).结论 EN支持可提高恶性胸水患者机体免疫功能,效果优于TPN支持.

BACKGROUND Chemotherapy plays an important role in the comprehensive therapy of lung cancer. However, the drug-resistance often causes the failure of the chemotherapy. The aim of this study is to identify differently expressed protein before and after cisplatin resistance of human lung adenocarcinoma cell A549 by proteomic analysis. METHODS Cisplatin-resistant cell strain A549/CDDP was established by combining gradually increasing concentration of cisplatin with large dosage impact. Comparative proteomic analysis of A549 and A549/CDDP were carried out by means of two-dimensional gel electrophoresis. The differentially expressed proteins were detected and identified by MALDI-TOF mass spectrometry. RESULTS Eighty-two differentially expressed proteins were screened by analysis the electrophoretic maps of A549 and A549/CDDP. Six differential proteins were analyzed by peptide mass fingerprinting. Glucose regulating protein 75, ribosomal protein S4, mitochondrial ATP synthase F1 complex beta subunit and immunoglobulin heavy chain variable region were identified. All four differentially expressed proteins were over-expressed in A549/CDDP, whereas low-expressed or no-expressed in A549. CONCLUSIONS These differentially expressed proteins give some clues to elucidate the mechanism of lung cancer cell resistant of cisplatin, providing the basis of searching for potential target of chemotherapy of lung cancer.