8010 Background: The phase III NEOTORCH trial demonstrated that perioperative toripalimab significantly improved event-free survival in stage IIIA–IIIB driver-gene-negative NSCLC, along with a favorable overall survival trend. However, the generalizability of randomized controlled trial (RCT) results to broader, more heterogeneous, real-world populations is uncertain. This study aimed to evaluate the effectiveness and safety of this regimen in routine clinical practice, providing essential evidence for treatment decisions. Methods: This nationwide, prospective, observational study in China consecutively enrolled patients with stage II-III NSCLC planned for perioperative treatment containing toripalimab. The primary endpoint was real-world event-free survival (rwEFS). Secondary endpoints included pathological complete response (pCR) rate, major pathological response (MPR) rate, objective response rate (ORR), R0 resection rate, real-world disease-free survival (rwDFS), real-world overall survival (rwOS), and safety. Results: Between December 9, 2024, and January 14, 2026, 1727 patients were enrolled from 221 tertiary and secondary hospitals across 28 provinces in China. Baseline characteristics: 82.8% male; 51.4% aged ≥65 years; ECOG PS 0/1/2 in 43.2%/54.4%/2.4%. Histology: 71.4% squamous, 18.3% nonsquamous, 10.3% NSCLC not otherwise specified. Clinical stage distribution: IIA (1.7%), IIB (10.4%), IIIA (52.8%), IIIB (33.0%), IIIC (2.1%). Of all enrolled patients, 542 (31.4%) were pending preoperative assessment. Surgery was not performed in 634 patients (36.7%); reasons included: other causes (64.9%), patient refusal (15.7%), surgical ineligibility (9.3%), disease progression (8.2%), and adverse events (1.9%). Ultimately, 551 patients (31.9%) underwent resection, with 503 having postoperative pathological assessment. The MPR rate was 67.0% (337/503) and the pCR rate was 39.6% (199/503). As of the data-cutoff, investigators reported 20 (1.2%) grade ≥3 or clinically significant treatment-emergent adverse events, with hematologic toxicities being most common. Immune-related adverse events were infrequent (four events: three grade 1–2 pneumonitis, one grade 3 rash). Conclusions: This is the largest prospective real-world study of perioperative immunotherapy in NSCLC to date. Its extensive geographic coverage and diverse patient population-including higher proportions of elderly patients, those with ECOG PS 1, and varied histologies-validate the effectiveness and manageable safety of perioperative toripalimab in routine practice beyond RCT settings. The significant pathological response rates observed support the clinical benefit of this regimen for a broad spectrum of stage II-III NSCLC patients, providing crucial evidence for real-world decision-making. Clinical trial information: ChiCTR2400091457.

BACKGROUND:Neoadjuvant chemoradiotherapy (CRT) remains the standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC), although distant recurrence continues to limit long-term survival. Neoadjuvant chemoimmunotherapy (CIT) has emerged as a potential systemic-focused alternative. This prospective multicenter study explored the comparative outcomes of neoadjuvant sintilimab plus chemotherapy versus CRT in resectable, clinical node-positive ESCC. METHODS:Consecutive adults with resectable, clinical node-positive (cN+) ESCC were enrolled across four academic centers. The patients received neoadjuvant sintilimab plus platinum-based chemotherapy (CIT) or standard CRT according to predefined institutional pathways in a nonrandomized design (2:1 enrollment). The primary endpoint was pathologic complete response (pCR). The secondary endpoints included nodal downstaging, perioperative outcomes, disease-free survival (DFS), overall survival (OS), and exploratory analyses of pretreatment inflammatory biomarkers. RESULTS:The 63 patients in this study completed neoadjuvant therapy followed by esophagectomy (CIT [n = 42] or CRT [n = 21]). The pCR rate was numerically higher with CRT than with CIT (52.4 % vs 31.0 %; p = 0.110). Nodal clearance was comparable (ypN0: 85.7 % vs 78.6 %; p = 0.735) with high R0 resection rates in both groups. During a median follow-up period of approximately 22 months, DFS did not differ significantly, whereas OS showed separation on unadjusted Kaplan-Meier analysis (p = 0.04, log-rank). Exploratory analyses showed no significant associations between pretreatment inflammatory biomarkers (neutrophil-to-lymphocyte ratio [NLR], monocyte-to-lymphocyte ratio [MLR], platelet-to-lymphocyte ratio [PLR], systemic immune-inflammation index [SII]) and pathologic response. Higher baseline SII was associated with OS in unadjusted comparisons. CONCLUSIONS:In this prospective nonrandomized cohort of clinical node-positive ESCC, CIT achieved nodal downstaging and R0 resection comparable with CRT but lower pCR. The observed survival difference should be interpreted cautiously and warrants validation in randomized trials.

As emerging environmental contaminants with suspected human health impacts, benzotriazole ultraviolet stabilizers (BUVSs) lack empirical evidence regarding pulmonary carcinogenicity in exposed populations, highlighting the need to investigate their potential association with lung cancer. This study aimed to analyze the relationship between urinary BUVSs concentrations and lung cancer risk within the general population of Hangzhou, China. This case-control study included 397 newly diagnosed lung cancer patients and an equivalent cohort of age- and sex-matched healthy controls. Urine samples were analyzed for five different types of BUVSs, with total concentrations ranging from 0.46 to 36.40 mu g/g creatinine. 2-(2 '-Hydroxy-3 ',5 '-di-tert-butylphenyl)-5-chloro-benzotriazole (UV-327) was the most prevalent, with a mean concentration of 5.09 mu g/g creatinine. Logistic regression models were employed to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) for assessing lung cancer risk in relation to urinary BUVSs concentrations. Following adjustment for covariates including sex, smoking status, alcohol intake, and dietary habits, urinary 2-(2H-benzotriazol-2-yl)-p-cresol (UV-P) was the only BUVS demonstrating a significant correlation with lung cancer risk. Participants in the highest urinary UV-P concentration group exhibited a 4.5-fold higher risk of lung cancer relative to those in the lowest group (adjusted OR = 4.55, 95 % CI:2.84-7.28, p for trend < 0.01). The link between elevated UV-P exposure and a higher risk of lung cancer was affected by factors such as smoking status and dietary habits. These findings provide novel evidence of a potential association between BUVSs exposure-particularly UV-P-and lung cancer in the general Chinese population, and highlight the need for future longitudinal and mechanistic studies to confirm these associations and elucidate the underlying biological pathways.

Nifuroxazide (NFX), an antibacterial agent, also exhibits notable antitumor effects by inhibiting STAT3 signaling, which is often aberrantly activated and linked to chemoresistance in tumors such as hepatocellular carcinoma (HCC). Combining NFX with chemotherapy may enhance therapeutic efficacy, but its poor solubility limits oral bioavailability. To address this, we developed a biomimetic delivery system by loading NFX into murine macrophage-like RAW264.7 cells (Mφ-NFX). This strategy aims to improve drug delivery, enhance antitumor effects, with the potential to circumvent or overcome drug resistance. We evaluated the efficacy of Mφ-NFX alone and in combination with Oxaliplatin in vitro and in preclinical HCC models. Macrophages effectively carried and delivered NFX to tumor cells and tissues without significant toxicity to the carriers. Additionally, NFX promoted macrophage polarization toward the M1 phenotype within the tumor microenvironment. Mφ-NFX significantly inhibited tumor growth and increased the M1/M2 macrophage ratio. Co-treatment with Mφ-NFX and Oxaliplatin demonstrated enhanced tumor suppression and modulation of the tumor microenvironment. Mechanistically, NFX and Oxaliplatin acted synergistically via inhibition of the AKT/β-catenin pathway. In conclusion, this macrophage-based NFX delivery platform offers improved antitumor activity and sensitization to chemotherapy, presenting a promising strategy for HCC treatment.

e14598 Background: In the ASTRUM-007 trial, serplulimab combined with chemotherapy significantly prolonged overall survival (OS) in patients with advanced esophageal cancer (EC). Despite these encouraging results, evidence regarding its efficacy and safety in the neoadjuvant setting remains absent. This nationwide real-world study evaluates the efficacy and safety of serplulimab-based neoadjuvant therapy in EC, addressing the anti-tumor activity and clinical feasibility. Methods: This nationwide, real-world, observational study was led by the First Affiliated Hospital, Zhejiang University School of Medicine and conducted across nine centers in China. This analysis included patients with histologically confirmed esophageal cancer who received serplulimab-based neoadjuvant therapy followed by radical surgery. Pathologic complete response (pCR), major pathologic response (MPR), the R0 resection rate, radiographic response during neoadjuvant treatment, and adverse events (AEs) were analyzed. Results: Between March 2022 and December 2023, a total of 95 EC patients who received serplulimab-based neoadjuvant therapy followed by radical surgery were included. The majority were male (n = 86, 90.53%), with a median age of 63 years, and 37 patients (38.95%) were aged ≥65 years. SCC accounted for 93 cases (97.89%) of the primary tumors, with most located in the middle thoracic esophagus (n = 68, 71.58%). Patients generally presented with heavy tumor burden, with 88 patients (92.63%) at stage T3/4 and 90 patients (94.74%) with positive lymph nodes. Of the 95 patients enrolled in the study, 89 underwent R0 resection, resulting in an R0 rate of 93.68%. The pCR rate was 23.16%, and the MPR rate was 41.05%. Tumor and nodal downstaging rates were 56.84% and 61.05%, respectively. Logistic regression showed that PD-L1-positive patients had significantly higher odds of achieving pCR (OR = 12.73, P = 0.016) and MPR (OR = 2.95, P = 0.031). Among 69 patients with measurable baseline lesions who underwent at least one radiological evaluation after initiating neoadjuvant therapy, 31 patients achieved partial response (PR) as the best response, resulting in an overall response rate (ORR) of 44.93% (95% CI: 32.92%–57.38%). The overall AE incidence was 96.84%, with 28.42% experiencing grade ≥3 AEs. The most common grade ≥3 AE was pneumonia, which occurred in 22.11% of patients. No new safety signals were identified, and patients generally tolerated the treatment well. Conclusions: This study represents the largest nationwide real-world investigation of serplulimab-based neoadjuvant therapy for esophageal cancer in China. The findings highlight the potential of serplulimab-based neoadjuvant therapy in transforming unresectable esophageal tumors into resectable disease with manageable toxicity.

Circular RNAs (circRNAs), the essential members of epigenetic reprogramming, are emerging as an appealing layer in hepatocellular carcinoma (HCC). Super-enhancers (SEs) are large clusters of transcriptional enhancers with the tremendous gene activation potential and are extensively investigated in cancer research. The present study explores and uncovers an SE-related circRNA circPVT1, identifying its biological functions and downstream mechanisms in HCC. CircPVT1 is upregulated in HCC, serving as an independent prognostic factor for patients with HCC. Enrichment of H3K27ac and H3K4me1 modifications has been confirmed at the genomic loci of circPVT1’s host gene, and the expression of circPVT1 is triggered by SEs. Functionally, circPVT1 enhances cell propagation and mobility capabilities in vitro, and facilitates tumour growth and metastasis in vivo. Mechanistically, circPVT1 recruits YBX1 into the cell nucleus, promoting the transcription of RRM2. Dysregulation of the circPVT1-RRM2 axis advances HCC malignancy, while inhibition of RRM2 or SE alleviates the effects of circPVT1 overexpression. In conclusion, our work demonstrates that circPVT1 is driven by super-enhancers. CircPVT1 promotes HCC progression via YBX1-mediated transcriptional activation of RRM2. These findings provide constructive insights into exploring the pathogenesis of HCC.

Non-genetic resistance of cancer remains poorly understood in clinical research and practice. To better understand resistant cancer cell heterogeneity, we isolated a novel riboflavin+NOTCH1+ population from cisplatin-naïve and -resistant lung cancer cell lines and patient specimens with or without immunotherapy and chemotherapy. This population was also identified as SLC52A2 (one of the riboflavin transporters)+NOTCH1+ cells in single-cell RNA sequencing (scRNA-seq) data derived from advanced lung tumors before therapy. Despite its therapy-naïve origin, the population, designated as stably resistant cancer cells (SRCC), exhibited the epithelial state, innate and stable resistance to therapy (chemotherapy, targeted therapy and immunotherapy), cell dormancy, elevated reactive oxygen species (ROS), and anti-apoptotic and anti-ferroptotic survival. These cellular and molecular characteristics distinguished SRCC from other resistant populations, including cancer stem-like cells (CSC), epithelial-mesenchymal transition (EMT) cells, and drug-tolerant persisters (DTP). The non-canonical NOTCH1 pathway, but not the inactivated canonical NOTCH1 pathway, played a critical role in the resistance of SRCC. Specifically, it modulates cell cycle, iron metabolism, EMT, and ferroptosis vulnerability in SRCC at the transcriptional level. It also controls the initiation of ferroptosis in lysosomes via a posttranslational NOTCH1-AKT-BAX axis. Inhibition of the non-canonical NOTCH1 pathway re-sensitizes these dormant and resistant cells to cisplatin-induced cell death in vitro and in vivo, including ferroptosis, apoptosis, and necroptosis. Our study contributes to a deeper understanding of cancer resistance and promotes the development of more effective therapeutic strategies against resistant cancer cells.

Abstract Background The standard care for resectable non-small cell lung cancer (NSCLC) involves perioperative therapy combining chemotherapy and immune checkpoint inhibitors, typically lasting 6 to 12 months. However, the optimal treatment strategies for potentially resectable squamous cell lung carcinoma (SCC) remain unclear. This Phase 2 trial aimed to assess the efficacy and safety of a condensed four-cycle perioperative treatment regimen with tislelizumab combined with chemotherapy in patients with potentially resectable stage III SCC. Methods Patients with potentially resectable stage IIIA-IIIB (N2) SCC received intravenous tislelizumab, albumin-bound paclitaxel, and carboplatin for up to four cycles. The primary endpoints were major pathologic response (MPR) and incidence of treatment-related adverse events. Safety and potential biomarkers for efficacy prediction were also assessed. Results Among 35 enrolled patients, 32 underwent surgery with R0 resection achieved in all cases. MPR was achieved in 24 patients and pathological complete response (pCR) in 14 patients. Radiographic objective response was observed in 31 patients. The 12-month and 24-month event-free survival rate was 85.7 and 61.0%, respectively. Four patients experienced grade 3 or 4 adverse events. Tumor tissue based next-generation sequencing revealed the potential associations between several biomarkers and pathological response, including tumor neoantigen burden score, 18-gene expression profile score, CD8 + T cells, M1/M2 macrophages ratio and interferon‐gamma expression level. Besides, circulating tumor DNA (ctDNA) dynamics and concentration were also associated with pathological response and the presence of ctDNA at postoperative month 1 was a strong predictor for disease relapse. Furthermore, metagenomic sequencing in bronchoalveolar lavage fluid demonstrated Streptococcus was the most abundant genus in the pCR group. Conclusions A condensed four-cycle perioperative treatment regimen of tislelizumab combined with chemotherapy demonstrated promising efficacy and manageable toxicities in potentially resectable stage III SCC. Specific biomarkers showed potential for predicting treatment efficacy and the mechanism of superior antitumor response of pCR patients was preliminarily and indirectly explored. Trial registration ClinicalTrials.gov, NCT05024266. Registered August 27, 2021.

Background:Aberrant methylation plays an essential role in early cancer development. In this study, we investigated methylation patterns in lung squamous cell carcinoma (LUSC) and matched non-tumor tissue and plasma samples to evaluate the potential of these patterns in the diagnosis of LUSC.Methods:The study group included 49 patients with stage I-III LUSC. We collected resected tumor tissue, paired peritumoral tissue, distant normal tissue, and corresponding plasma samples. A bespoke lung cancer bisulfite sequencing panel was used to profile the methylation level. Another 48 healthy volunteers provided control plasma samples.Results:Peritumoral and distant normal tissues presented similar methylation signatures, distinct from those in tumor tissue samples. A comparison of methylation profiles led to the identification of 871 tumor-specific differentially methylated blocks, including 847 hypermethylated and 24 hypomethylated blocks (adjusted P value <0.05). All top-ranked blocks were tumor-related. Tissue samples were analyzed for field cancerization to identify progressively aggravating aberrant methylations during tumor initiation and development. The analysis revealed that 221 blocks presented a stepwise increase in methylation levels, while seven blocks presented a stepwise decrease in methylation pattern as the sampling drew nearer to the tumor. The malignant contaminated ratio (MCR) confirmed the presence of distinct methylation patterns between tumor and peritumoral tissue samples. We then constructed a diagnostic panel using a combined diagnostic score of cell-free DNA (cfDNA) that showed high sensitivity and specificity. The healthy controls had a significantly lower combined diagnostic score (cd-score) than LUSC patients. Additionally, based on the methylation profiles, LUSC could be classified into two subgroups, C1 and C2. The methylation profile of the C2 group was not distinct from the healthy controls, which had a significantly lower cd-score than did the C1 group.Conclusions:LUSC-specific methylation patterns could potentially discriminate between peritumoral tissue, distant normal tumor tissue, and tumor tissues. This preliminary study also supported the potential utility of cfDNA methylation analysis in diagnosing LUSC.

Abstract Background Locally advanced non-small cell lung cancer (NSCLC) with N1/N2 lymph node metastasis is challenging with poor survival. Neo-adjuvant chemo-immunotherapy has gained benefits in a proportion of these patients. However no specific biomarker has been proved to predict the effect before therapy. In addition, the relationship of nodal status and survival after neo-adjuvant chemo-immunotherapy is still not well stated. Methods A total of 75 resectable NSCLC patients with N1/N2 stage who received neo-adjuvant chemo-immunotherapy plus surgery were retrospectively studied. The clinical characteristics, surgical information and safety parameters were collected. The correlations of major pathological response (MPR) and pathological complete response (pCR) with clinical data were analyzed. The progression free disease(PFS) and overall survival(OS) were evaluated with pathological response and nodal status. Results Of the 75 patients, 69 (92%) patients experienced treatment related adverse effects, while grade 3–4 adverse effects occurred in 8 (10%) patients. All the patients received surgical R0 resection with a MPR rate of 60% and a pCR rate of 36%. 67% of N1 patients and 77% of N2 patients had nodal clearance after neo-adjuvant treatment. A significant difference was observed between pathological response with age, histology and multiple lymph node metastasis. The PFS was better in the MPR cohort. The PFS was 90.1% and 83.6% at the nodal clearance group at the time of 12 and 18 months, compared with 70.1% and 63.7% at the nodal residual group. Conclusions The neo-adjuvant chemo-immunotherapy for locally advanced NSCLC with nodal positive was safe and feasible. The patients with elder age and squamous-cell carcinoma (SCC) were more likely to have better pathological response, while multiple nodal metastasis was a negative predictor. The clearance of lymph node resulted in significantly longer PFS and OS.

Introduction: Video-assisted thoracic surgery (VATS) has been widely accepted in the diagnosis and treatment of thoracic diseases for the past three decades due to its small incision, minimal trauma, and rapid recovery after surgery. A growing number of patients with concurrent pulmonary nodules and mediastinal lesions have been detected. Simultaneous ipsilateral resection of coexisting lesions is a preferred procedure. Aim: To introduce our technique and preliminary experience in performing uniportal video-assisted thoracic surgery (VATS) for the simultaneous resection of pulmonary and mediastinal lesions. Material and methods: We retrospectively analysed 8 consecutive patients who underwent simultaneous uniportal VATS resection of coexisting lesions of the lung and mediastinum in our centre. The clinical data were recorded and analysed. Results: A total of 8 patients were enrolled, and all patients successfully underwent surgery through a single incision; no perioperative deaths occurred. The average single incision length was 3.9 +/- 0.3 cm, the operative time was 102.3 +/- 54.4 min, and the bleeding volume was 27.5 +/- 17.9 ml. The thoracic drainage time was 3.0 +/- 2.3 days, with a mean volume of 390.6 +/- 361.3 ml. The length of postoperative hospital stay was 4.0 +/- 1.9 (range: 3-9) days. No serious complications were observed in the hospital or during postoperative follow-up. Conclusions: Uniportal VATS is feasible and safe for the simultaneous resection of pulmonary and mediastinal lesions in selected patients and offers cosmetically pleasing incisions and promising clinical application prospects.

Background: This study aims to identify the feasibility of uniportal video-assisted thoracoscopic surgery (VATS) and robot-assisted thoracoscopic surgery (RATS) compared with multiportal VATS in the resection of mediastinal lesions. Methodes: Patients who underwent mediastinal lesion resection were enrolled and allocated to the uni-VATS, tri-VATS, and RATS groups according to the surgical approach. Propensity score-matched (PSM) analysis was performed between the VATS and RATS groups as well as the uni-VATS and tri-VATS groups. The operative and recovery parameters were compared. Results: Totally, 274 patients were enrolled. There was no difference in the operative parameters among the groups. Compared with multiportal VATS, uniportal VATS and RATS had a significantly shorter chest tube placement time (2.43 +/- 0.88 vs. 1.78 +/- 1.22 vs. 2.21 +/- 1.11 days, P<0.001) and hospital length of stay (LOS) (4 .07 +/- 1.75 vs. 3.27 +/- 1.05 vs. 3.62 +/- 1.21 days, P=0.001) without increasing the incidence rate of complications (5.6% vs. 7.2% vs. 5.7%, P=0.864). After PSM, the RATS group showed a significantly lower unplanned conversion rate than the VATS group (0.0% vs. 8.2%, P=0.041), while the uni-VATS group had a shorter chest tube placement time (1.83 +/- 1.20 vs. 2.35 +/- 0.86 days, P=0.013) and hospital LOS (3.23 +/- 1.03 vs. 3.95 +/- 2.00 days) than the tri-VATS group. Conclusions: Compared with multiportal VATS, uniportal VATS and RATS are technically safe and feasible with potential advantages for mediastinal lesion resection.

With the development of computer technology, screening cancer biomarkers based on public databases has become a common research method. Here, an eight-gene prognostic model, which could be used to judge the prognosis of patients with lung adenocarcinoma (LUAD), was developed through bioinformatics methods. This study firstly used several gene datasets from GEO database to mine differentially expressed genes (DEGs) in LUAD tissue and healthy tissue via joint analysis. Later, enrichment analysis for the DEGs was performed, and it was found that the DEGs were mainly activated in pathways involved in extracellular matrix, cell adhesion, and leukocyte migration. Afterward, a TCGA cohort was used to perform univariate Cox, least absolute shrinkage and selection operator method, and multivariate Cox regression analyses for the DEGs, and a prognostic model consisting of eight genes (GPX3, TCN1, ASPM, PCP4, CAV2, S100P, COL1A1, and SPOK2) was established. Receiver operation characteristic (ROC) curve was then used to substantiate the diagnostic efficacy of the prognostic model. The survival significance of signature genes was verified through the GEPIA database, and the results exhibited that the risk coefficients of the eight genes were basically congruous with the effects of these genes on the prognosis in the GEPIA database, which suggested that the results were accurate. Finally, combined with clinical characteristics of patients, the diagnostic independence of the prognostic model was further validated through univariate and multivariate regression, and the results indicated that the model had independent prognostic value. The overall finding of the study manifested that the eight-gene prognostic model is closely related to the prognosis of LUAD patients, and can be used as an independent prognostic indicator. Additionally, the prognostic model in this study can help doctors make a better diagnosis in treatment and ultimately benefit LUAD patients.

BACKGROUND:After general thoracic surgery, a chest tube is usually placed for closed drainage to expel gas accumulation in the thoracic cavity and fluid accumulation to promote lung re-expansion. It can also be observed whether there is active bleeding after the operation and whether there is a pulmonary leak. The conventional drainage of the chest cavity is connected with a water-sealed drainage bottle, and the patient condition is judged by observing the drainage situation and the fluctuation of the water column, which is a very classic method. However, the water-sealed bottle has the disadvantages of being easy to overturn and inconvenient to carry, which is not conducive to the early activities of patients. Under the concept of accelerated rehabilitation, our center applied a new type of anhydrous thorax negative pressure drainage device and achieved good results. The purpose of this study was to observe the effect of a new type of anhydrous thoracic negative pressure drainage device in patients after thoracic surgery.METHODS:Retrospective analysis of patients who underwent lung surgery in the First Affiliated Hospital of Zhejiang University Medical College from January 2018 to December 2019, patients were divided into two groups. One group of patients used a traditional closed-chest drainage water-sealed bottle as a control group, and the other group used a new type of anhydrous negative-pressure drainage bottle as an experimental group. Patients' gender, age, hypertension, diabetes, smoking history, surgical incisions and surgical methods, and the length of hospital stay and postoperative hospital stay were calculated.RESULTS:There were no statistical differences in age, gender, comorbidities (hypertension, diabetes, smoking history), scope of surgery, and duration of surgery between the two groups of patients, but there were statistical differences in surgical incisions between the two groups of patients (P=0.01). We found that patients using the new waterless negative pressure drainage device were shorter than patients with water negative pressure drainage device in terms of postoperative hospital stay and total hospitalization time, and the difference was statistically significant (P=0.02, P=0.04).CONCLUSIONS:The new type of anhydrous thoracic negative pressure drainage device has a good effect on the rapid recovery and advancement after thoracic surgery.

Lung transplantation is the only effective treatment for end-stage lung diseases. Bronchiolitis obliterans, which is known as non-infectious chronic lung allograft dysfunction (CLAD) in the new classification, is the greatest threat to long-term survival after lung transplantation. This study investigated the role of leukotriene B4 (LTB4) and montelukast in transplantation-related bronchiolitis obliterans and discussed the pathophysiological significance of LTB4 in chronic rejection.

目的 探讨前降钙素原(PCT)对中国与马里危重恶性疟疾患者的影响.方法 将63例恶性疟疾患者分成中国患者组(n=28)与马里患者组(n=35),分别记录所有患者治疗前及治疗后1、3、7d的PCT水平、疟原虫数量及急性病生理学和长期健康评价(APACHE)Ⅱ评分.对疟原虫数量、APACHEⅡ评分与PCT水平关系采用Pearson相关分析.结果 中马两组患者治疗后PCT水平(F=5.9、7.4,P均＜0.05)、疟原虫数量(F=24.6、35.1,P均＜0.05)及APACHEⅡ评分(F=29.8、37.4,P均＜0.05)较治疗前均显著下降.且APACHEⅡ评分在治疗后个时间点比较,中国患者组较马里患者组下降更明显(t=15.9、17.2、23.4,P均＜0.05).Pearson相关分析提示PCT水平与各时间点疟原虫数量呈正相关(r=0.52、0.87、0.69、0.54,P均＜0.05),但与APACHEⅡ评分不相关(P均＞0.05).结论 PCT能够反映中国与马里恶性疟疾患者疟原虫感染程度及治疗前后变化,对恶性疟疾诊断及指导治疗有一定帮助,但不能完全反映临床病情及疾病预后.

Objective To investigate the clinical features and the mechanism of falciparum malaria in several patients between Chinese and Malian.Methods The data of Chinese (n =28) and Malian patients (n =35) including general condition,Glasgow Coma Scale (GCS),APACHE Ⅱ,the time of applying ventilator and days of stay in ICU,laboratory examination (plasmodium test,routine blood test,liver and kidney function and C-reactive protein (CRP) assayed before treatment and 1d,3d,7d after treatment,cranial computed tomography and mortality were recorded for investigating the clinical features of the disease.Results There was difference in age range between Chinese patients (ranged from 32 to 50 years old) and Malian patients (ranged from 8 to 72 years old),and difference in severity of the disease between patients of two countries was found and Malian patients were more severely infected than Chinese patients.The results of plasmodium test,routine blood test,liver and kidney function and level of CRP often varied greatly during the entire course of the disease,and the changes were greater in Malian patients.The correlation between APACHE Ⅱ and CRP was found (P ＜ 0.05).The cranial CT displayed ischemia focus in brain.The mortality of Chinese patients was 16.7％ and that of Malian was 25.0％.Conclusions There was difference in composition of residents between Chinese patients and Malian patients.Malian patients were more severely infected with Plasmodium falciparum than Chinese patients,and this difference might be due to the potential correlation between the disease virulence and immune response of patients.

Trauma is the main contributing factor which can cause rupture in diaphragm. Diaphragm is rarely ruptured spontaneously, esp. without any prior traumatic event or significant medical history. Here we present a spontaneous diaphragmatic tear. The diagnosis was made by emergent thoracic and abdominal CT-Scan, as well as by the thoracotomy and a rapid repair and the resection of the strangulated bowel was achieved by laparotomy. In these situations, early diagnosis and rapid surgical intervention are necessary for successful treatment of affected individuals.

目的 观察依达拉奉和甘露醇对体外循环(CPB)心脏手术后心肌缺血再灌注损伤的保护作用.方法 将CPB心脏手术后的80例患者随机分为依达拉奉组、甘露醇组、依达拉奉联合甘露醇组(联合组)和对照组,每组各20例,同时分别于术前及主动脉开放后2、4、12和24 h时测定血超氧化物歧化酶(SOD)活性及丙二醛(MDA)、肌酸磷酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)含量.结果 CPB术后各组血CK-MB、cTnI、MDA水平均较术前明显升高,依达拉奉组、甘露醇组及联合组术后各时间点的血CK-MB、cTnI、MDA水平均较对照组降低(均P＜0.05或0.01);各组患者血SOD水平在开放主动脉后均较术前下降,依达拉奉组、甘露醇组及联合组在术后各时点的血SOD下降水平均低于对照组(均P＜0.05).结论 依达拉奉和甘露醇均可以提高心肌细胞血SOD活性,减少血MDA的产生,从而减轻心肌缺血再灌注损伤,有效的保护心肌功能.

Postmediastinal schwannoma is a kind of neurogenic tumor originating from the neuron sheath in the posterior mediastinum. In the majority of cases these tumors are located in the paravertebral sulcus and the incidence is similar in both sides of the thorax as single or multiple; however, multi-schwannomas involved in the bilateral postmediastinum are rare. We report a case of postmediastinal multi-schwannomas and discuss the clinical and surgical treatment. We are aware of no previously published reports on this rare condition.