To our knowledge, this is the first reported case of coexisting esophageal schwannoma and gastric fundus gastrointestinal stromal tumor (GIST). This case report describes the diagnostic and treatment process of a patient with esophageal schwannoma who also had a concurrent gastric fundus GIST and was presented to Hebei General Hospital (Hebei, China) in October 2024. The association between the pathogenesis of the two types of submucosal gastrointestinal tumors is unclear, with limited existing evidence in the literature. The esophageal schwannoma was misdiagnosed as a leiomyoma preoperatively, which prompted us to seek new diagnostic modalities to differentiate gastrointestinal submucosal lesions (leiomyomas, GISTs, and schwannomas). Surgical resection is considered the optimal treatment for esophageal schwannoma. The patient underwent a right single-port thoracoscopic esophageal tumor resection and recovered well, subsequently being discharged smoothly from the hospital.

Background: Posterior mediastinal leiomyosarcoma is an extremely rare malignant mesenchymal tumor with no special clinical symptoms, which is easily confused with some common tumors in the posterior mediastinum, affecting the accuracy of the first diagnosis by clinicians and delaying the treatment of patients. Case summary: We report a 59-year-old woman with a space-occupying lesion in the posterior mediastinum. The patient was mistakenly diagnosed with lumbar muscle or vertebral body lesions due to chest and back pain and underwent conservative treatment, but her symptoms did not improve significantly and she gradually developed pain in both lower limbs. Chest computed tomography (CT) scan indicated the left lower lung paraspinal space and underwent standard single-aperture video-assisted thoracoscopic surgery (VATS), which was pathologically confirmed as posterior mediastinal leiomyosarcoma. Conclusion: Complete surgical resection of posterior mediastinal leiomyosarcoma can achieve good clinical results.

With advancements in imaging testing and surgical procedures, an increasing number of nodules with smaller diameters and deeper locations have been deemed suitable for surgical intervention. The preoperative localization of these nodules has become essential. In this retrospective single-center study, we aimed to compare the effectiveness and patient comfort associated with the use of a four-hook needle versus a hook-wire needle for preoperative localization. Additionally, we sought to evaluate the impact of different patient postures on localization effectiveness. We retrospectively analyzed the data of 692 patients following preoperative CT-guided localization. The patients were categorized into different groups based on the type of localization needles used and their respective postures during localization. There was no statistical difference in total complications between the four-hook needle group and the hook-wire needle group (P > 0.05). The chest pain score in the four-hook needle group was lower than the hook-wire needle group (P = 0.001). The incidence of decoupling in the four-hook needle group was significantly lower than the hook-wire needle group (P < 0.05). The four-hook needle group had better performance in terms of localization operation time, operation time, intraoperative bleeding and first-day drainage (P < 0.05). Compared with the supine and lateral groups, the prone posture group had better performance in total complications and localization operation time, and worse performance in decoupling and chest pain (P < 0.05). The four-hook needle has better effectiveness on localization and comfort in patient than the hook-wire needle, which is worthy of clinical promotion and application. The patient’s different postures during localization procedure may affect the localization results.

目的 建立人肺腺癌A549细胞株裸鼠移植瘤模型,用增敏剂量的β-榄香烯联合放疗对移植瘤进行干预,探讨放疗增敏机制是否与抑制葡萄糖转运蛋白1(GLUT-1)表达有关.方法 采用细胞悬液接种法建立裸鼠移植瘤模型,将肿瘤体积达到75 mm3左右的20只裸鼠随机分为空白对照组(NS组)、β-榄香烯单药组(ELE组)、β-榄香烯联合放疗组(ELE+RAD组)和单纯放疗组(RAD组).监测干预后各组裸鼠肿瘤体积的变化,获得各组裸鼠的肿瘤生长曲线.通过计算增敏系数,检测45 mg·kg-1 β-榄香烯是否发挥增敏作用,采用Real-Time PCR、Western blotting及免疫组化染色检测各组移植瘤中GLUT-1的表达水平.结果 成功建立A549细胞株裸鼠移植瘤模型,依据各组移植瘤体积变化绘制生长曲线.测得增敏系数(EF)为2.44,提示β-榄香烯的剂量已达到增敏效果.与NS组相比,实验组移植瘤GLUT-1 mRNA及蛋白表达水平均显著降低(P＜0.01);ELE组与RAD组GLUT-1 mRNA及蛋白表达水平无显著差异(P＞0.05);与ELE组、RAD组相比,ELE+RAD组GLUT-1 mRNA及蛋白表达水平均显著降低(P＜0.01).免疫组化结果显示,与NS组比较,实验组GLUT-1的表达均被显著抑制(P＜0.05);其中ELE组和RAD组GLUT-1的表达抑制作用相对较弱,RAD组的抑制作用略强于ELE组,但两组差异无统计学意义(P＞0.05);而ELE+RAD组GLUT-1的表达抑制作用较强(P＜0.05).结论 增敏剂量的β-榄香烯与放疗联合应用可显著抑制裸鼠移植瘤中GLUT-1 mRNA及蛋白表达,明显增强放疗对肺癌裸鼠移植瘤的生长抑制效果,提示β-榄香烯可能通过抑制GLUT-1表达发挥放疗增敏作用.

Abstract Background The structure or function of the centrosome can cause abnormal cell proliferation, leading to tumors. There is increasing evidence that the centrosome is closely associated with the occurrence and development of lung adenocarcinoma (LUAD). We aim to construct a new centrosome-related genes (CRGs) prognostic model in this study. Methods The gene expression data of LUAD can be downloaded from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. We used the R to identify differentially expressed genes between normal and malignant lung tissues, constructed a CRGs risk score, evaluated the prognostic value of clinical data in different subgroups with different CRGs risk score signature to construct a CRGs risk model. Result A total of 779 CRGs were detected, and three genes related to prognosis were screened, including ID1, LATS2 and PRKCZ, and CRGs. Risk score was constructed based on these three genes, and its accuracy was verified in the GEO dataset. The prognosis is significantly lower in the high-risk group, and this feature can be used as an independent prognostic factor. In addition, the immune and mutation landscape between the different subgroups were found to be significantly different. We found that the Tumor Immune Dysfunction and Exclusion (TIDE) score of the high-risk group was significantly increased, indicating that the low-risk group is more likely to benefit from immunotherapy. Conclusion The research results suggest that the CRGs risk model may be a reliable prognostic model for personalized treatment of LUAD patients.

目的 观察中医药联合快速康复外科(ERAS)在胸外科围手术期患者中的应用效果.方法 选取 2019年6 月至2019 年12 月河北省人民医院胸外科围手术期住院患者80 例,按照随机数字表法分为2 组,对照组40 例予常规ERAS手段治疗,治疗组40 例在对照组基础上联合中医药治疗(针刺疗法联合中药口服).观察比较2 组术后首次排气时间、首次排便时间、首次摄入固体食物时间、首次离床活动时间、胸腔引流量及引流管拔除时间情况,比较 2 组术后疼痛、恶心呕吐、腹胀、乏力症状评分变化情况,比较2 组住院时间、住院费用及住院满意度评分情况,比较2 组术后并发症肺不张、下肢深静脉血栓形成、气胸的发生情况.结果 2 组术后首次排气时间、首次排便时间、首次摄入固体食物时间比较差异均有统计学意义(P<0.05),治疗组所需时间均短于对照组,但 2 组首次离床活动时间、胸腔引流量及引流管拔除时间比较差异无统计学意义(P>0.05).2 组术后疼痛、恶心呕吐、腹胀及乏力症状评分比较差异均有统计学意义(P<0.05),治疗组各项评分均低于对照组.2 组住院时间及住院满意度评分情况比较差异均有统计学意义(P<0.05),治疗组住院时间短于对照组,住院满意度评分高于对照组,但 2 组住院费用比较差异无统计学意义(P>0.05).治疗组术后并发症总发生率2.5%(1/40),对照组术后并发症总发生率15.0%(6/40),治疗组术后并发症总发生率低于对照组(P<0.05).结论 中医药联合ERAS在胸外科围手术期患者的应用中优势明显,可以有效促进患者术后康复,减轻术后症状,预防术后并发症的发生,同时具有良好的安全性,并获得了患者的广泛认可.

BackgroundA comprehensive understanding of the anatomical variations in the pulmonary bronchi and arteries is particularly essential to the implementation of safe and precise left superior division segment (LSDS) segmentectomy. However, no report shows the relationship between the descending bronchus and the artery crossing intersegmental planes. Thus, the purpose of the present study was to analyze the branching pattern of the pulmonary artery and bronchus in LSDS using three-dimensional computed tomography bronchography and angiography (3D-CTBA) and to explore the associated pulmonary anatomical features of the artery crossing intersegmental planes. Materials and methodsThe 3D-CTBA images of 540 cases were retrospectively analyzed. We reviewed the anatomical variations of the LSDS bronchus and artery and assorted them according to different classifications. ResultsAmong all 540 cases of 3D-CTBA, there were 16 cases (44.4%) with lateral subsegmental artery crossing intersegmental planes (AX(3)a), 20 cases (55.6%) Without AX(3)a in the descending B(3)a or B-3 type, and 53 cases (10.5%) with AX(3)a, 451 cases (89.5%) Without AX(3)a in the Without the descending B(3)a or B-3 type. This illustrated that the AX(3)a was more common in the descending B(3)a or B-3 type (P < 0.005). Similarly, there were 69 cases (36.1%) with horizontal subsegmental artery crossing intersegmental planes (AX(1 + 2)c), 122 cases (63.9%) Without AX(1 + 2)c in the descending B(1 + 2)c type, and 33 cases (9.5%) with AX(1 + 2)c, 316 cases (90.5%) Without AX(1 + 2)c in the Without the descending B(1 + 2)c type. Combinations of the branching patterns of the AX(1 + 2)c and the descending B(1 + 2)c type were significantly dependent (p < 0.005). The combinations of the branching patterns of the AX(1 + 2)c and the descending B(1 + 2)c type were frequently observed. ConclusionsThis is the first report to explore the relationship between the descending bronchus and the artery crossing intersegmental planes. In patients with the descending B(3)a or B-3 type, the incidence of the AX(3)a was increased. Similarly, the incidence of the AX(1 + 2)c was increased in patients with the descending B(1 + 2)c type. These findings should be carefully identified when performing an accurate LSDS segmentectomy.

Aim: To assess the potential factors with predictive value for survival in small-cell lung cancer (SCLC) patients and to develop a nomogram prediction model. Patients & methods: We retrospectively screened and analyzed patients with pathologically confirmed SCLC from April 2015 to December 2021. Results: A total of 167 patients with SCLC were included. According to the Memorial Sloan-Kettering prognostic score (MPS), patients were divided into three groups: group 0 (n = 65), group 1 (n = 69) and group 2 (n = 33). The multivariate analysis showed that MPS was an independent prognostic factor for progression-free and overall survival in SCLC patients (p < 0.05). The nomogram showed that MPS was the most influential factor for overall survival. Conclusion: MPS is an independent prognostic factor for overall and progression-free survival in SCLC patients and performed better than other indicators used in this study.

Objective Lung cancer is a malignancy with high a mortality rate that threatens human health. This study is aimed to explore the correlation among the triglyceride/high-density lipoprotein ratio (TG/HDL-C), non-high-density lipoprotein/high-density lipoprotein ratio (non-HDL-C/HDL-C) and survival of patients with non-small cell lung cancer (NSCLC) undergoing video-associated thoracic surgery (VATS). Methods This retrospective study analyzed 284 patients with NSCLC who underwent VATS at Hebei General Hospital, Shijiazhuang, China. The time-dependent receiver operating characteristic curve was used to determine the optimal cutoff value and evaluate the area under the curve. Kaplan–Meier and Cox regression analyses were performed to determine the prognostic effect. Results The median overall survival (OS) was 46 months. Patients with low TG/HDL-C and low non-HDL-C/HDL-C had a longer OS. The low non-HDL-C/HDL-C group showed a longer mean survival time (59.00 vs. 52.35 months). Multivariate analysis revealed that TG/HDL-C and non-HDL-C/HDL-C were significantly correlated with OS. Conclusions TG/HDL-C and non-HDL-C/HDL-C are associated with the prognosis of patients with NSCLC who received VATS. Preoperative serum TG/HDL-C and non-HDL-C/HDL-C may be effective independent prognostic factors for predicting the outcomes of patients with NSCLC.

Objective This study intends to explore the factors affecting the growth of pulmonary nodules in the natural process by immunohistochemical method. Methods 40 cases of pulmonary nodules followed up for more than 3 years were divided into growth group (n = 20) and stable group (n = 20). The expressions of cyclooxygenase-2 (COX-2), Ki67, vascular endothelial growth factor (VEGF), CD44V6, epidermal growth factor receptor (EGFR), double microsome 2 (MDM2) and transforming growth factor (TGF)-β1 in pulmonary nodules were detected by immunohistochemical method so as to explore the relationship between it and the growth of pulmonary nodules. Results Compared with stable pulmonary nodules, the positive rates of COX-2, Ki67 and VEGF in the growth group were 85%, 80% and 55%, respectively. There was significant difference between the stable group and the growth group (P < 0.05). The correlation between other indexes and the growth of pulmonary nodules was not statistically significant (P cd44v6 = 0.104;P EGFR = 0.337; P MDM2 = 0.49; P TGF-β1 = 0.141). In the subgroup of patients with non-invasive lung cancer, there was a correlation between VEGF and the growth of pulmonary nodules (P < 0.05). Conclusion The high expression of COX-2, Ki67 and VEGF proteins may be significantly related to the growth of pulmonary nodules, and VEGF may be an important factor affecting the growth of malignant pulmonary nodules. This study intends to provide a research direction for further searching for the essential causes of the growth of pulmonary nodules.

Abstract Background：In recent years, studies have validated that serum lipids and lipoproteins are related to the prognosis of non-small cell lung cancer. However, the correlation between the ratio of triglyceride to high-density lipoprotein (TG/HDL-C) or the non- high-density lipoprotein to high-density lipoprotein ratio (non-HDL-C/HDL-C) and survival of patients undergoing video-assisted thoracic surgery (VATS) in stage Ⅰ-ⅢA of non-small cell lung cancer is unclear. This study uses a retrospective approach to evaluate the relationship between TG/HDL-C or non-HDL-C/HDL-C and prognosis of patients with non-small cell lung cancer.Methods：We retrospectively analyzed 284 patients in stage I-IIIa non-small cell lung cancer who underwent thoracoscopic surgery in Hebei General Hospital. The Time-dependent Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value and the area under the ROC curve. Survival analysis was implemented through Kaplan-Meier and Cox regression analyses.Result：Median OS is 46 months. The cutoff value of TG/HDL-C ratios is 1.379. The cutoff value of non-HDL-C/HDL-C ratios is 2.530. The low TG/HDL-C group has a longer mean survival time (56.61 vs. 46.81 months, P < 0.05). The low non-HDL-C/HDL-C group has a longer mean survival time (59.00 vs. 52.35 months, P < 0.05).Conclusion：TG/HDL-C and non-HDL-C/HDL-C ratios have a certain correlation with the survival and prognosis of non-small cell lung cancer patients receiving VATS. Preoperative serum TG/HDL-C and non-HDL-C/HDL-C may be effective independent prognostic factors for predicting NSCLC patients.

Objective The advanced lung cancer inflammation index (ALI) can predict the survival of patients with lung cancer and other malignancies. However, the prognostic significance of ALI in neuroblastoma has not been reported. This study aimed to evaluate the correlation between ALI and neuroblastoma patient prognosis. Methods We retrospectively analyzed the data of 72 neuroblastoma patients treated between January 2014 and August 2020. ALI calculation: Body mass index (BMI) × serum albumin (ALB)/neutrophil-to-lymphocyte ratio (NLR). The optimal cutoff points of prognostic biomarkers were determined by generating receiver operating characteristic (ROC) curves. According to the cutoff value, the patients were categorized into low or high ALI groups. The chi-square test was used to compare clinical parameters between the two groups. Potential prognostic factors associated with overall survival (OS) were assessed using Kaplan–Meier and Cox regression analyses. Results The optimal cutoff value of ALI was 49.17. The low ALI group showed more severe clinical characteristics and poorer survival rates. Univariate and multivariate Cox analyses suggested that ALI and the International Neuroblastoma Staging System (INSS) stage were independent prognostic factors for neuroblastoma patients. Conclusions Low ALI is associated with poor prognosis in neuroblastoma patients. ALI may be an independent prognostic biomarker for neuroblastoma.

PURPOSE:Advanced lung cancer inflammation index (ALI) has been shown to predict overall survival (OS) in advanced non small-cell lung cancer (NSCLC), small-cell lung cancer (SCLC) and operable NSCLC. However, there were no studies of the correlation between ALI and operable SCLC. Therefore, this study is aimed to explore the relationship between ALI and the prognosis of operable SCLC. PATIENTS AND METHODS:A total of 48 patients with SCLC who underwent surgery at Hebei General Hospital and Zigong First People's Hospital were screened between 2016 and 2020. ALI was calculated as follows: body mass index (BMI, kg/m2)×serum albumin (ALB, g/dL)/neutrophil to lymphocyte ratio (NLR). Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff value of ALI. Patients were divided into two groups according to the cutoff point of ALI: low ALI group with ALI<48.2 and high ALI group with ALI≥48.2. Kaplan-Meier and Cox regression analysis were performed to assess the potential prognostic factors associated with OS. RESULTS:The optimal cutoff value of ALI was determined as 48.2. The low ALI group displayed more adverse clinical characteristics and poorer survival rates. Multivariate analysis revealed that ALI and Charlson comorbidity index (CCI) were significantly correlated with OS. CONCLUSION:Low ALI was correlated with poor prognosis in patients with SCLC who underwent surgery. Preoperative ALI might serve as a potential prognostic marker for patients with operable SCLC.

目的 研究缺氧诱导因子-1α(HIF-1α)对人肺腺癌A549细胞株及人小细胞肺癌H446细胞株的凋亡、增殖的影响,以及HIF-1α表达与Livin、Caspase-3表达的关系.方法 常规培养A549、H446细胞,转染含有HIF-1α基因的质粒过表达HIF-1α基因,筛选干扰序列干扰HIF-1α基因表达,将对数生长期细胞随机分成对照组、HIF-1α过表达组和HIF-1α干扰组.应用Annexin V-PI凋亡检测试剂盒及流式细胞仪检测细胞凋亡;应用Transwell小室检测细胞迁移及侵袭;Real-time PCR及Western Blot检测Livin、Caspase-3表达.结果 A549细胞HIF-1α过表达组较对照组凋亡显著减少(P<0.01),迁移及侵袭细胞数明显增多(P<0.05),Livin mRNA表达显著增多(P<0.01),Caspase-3 mRNA及蛋白表达明显减少(P<0.05),Livin蛋白表达差异无统计学意义(P>0.05);A549细胞HIF-1α干扰组较对照组晚期凋亡细胞明显增多(P<0.05),迁移及侵袭细胞数均显著减少(P<0.01),Livin在mRNA和蛋白水平表达明显减少(P<0.05),Caspase-3 mRNA及蛋白表达显著增多(P<0.01);H446细胞HIF-1α过表达组与对照组比较,细胞凋亡、侵袭以及Caspase-3 mRNA表达均无统计学差异(P>0.05),细胞迁移明显增多(P<0.05),Livin在mRNA和蛋白水平表达均显著增多(P<0.01),Caspase-3蛋白表达明显减少(P<0.05);H446细胞HIF-1α干扰组较对照组凋亡显著增多,迁移及侵袭细胞数均显著减少(P<0.01),Livin蛋白表达显著减少,Caspase-3在mRNA及蛋白水平表达显著增多(P<0.01);Livin mRNA表达减少无统计学意义(P>0.05).结论 抑制HIF-1α表达均可通过增加凋亡、减少迁移与侵袭达到抑制肺癌肿瘤进展的效果,在理论上证实HIF-1α可以作为肺癌治疗靶点;肺癌细胞中HIF-1α与Livin的表达呈正相关,Caspase-3与HIF-1α、Livin的表达呈负相关,可能是通过抑制HIF-1α 以上调Livin、下调Caspase-3表达作为肺癌治疗的靶点.

and Cox regression analysis were performed to assess the potential prognostic factors associated with OS. Results: The optimal cutoff value of ALI was determined as 48.2. The low ALI group displayed more adverse clinical characteristics and poorer survival rates. Multivariate analysis revealed that ALI and Charlson comorbidity index (CCI) were significantly correlated with OS. Conclusion: Low ALI was correlated with poor prognosis in patients with SCLC who underwent surgery. Preoperative ALI might serve as a potential prognostic marker for patients with operable SCLC.

Objective The advanced lung cancer inflammation index (ALI) predicts overall survival (OS) in patients with advanced lung cancer. However, few studies have tested ALI’s prognostic effect in patients with non-small cell lung cancer (NSCLC) following video-assisted thoracic surgery (VATS), especially patients at stage III. This study investigated the relationship between ALI and outcomes of patients with NSCLC following VATS. Methods We retrospectively examined 339 patients with NSCLC who underwent VATS at Hebei General Hospital, China. Preoperative clinical and laboratory parameters were collected and analyzed. Optimal cutoff values of potential prognostic factors, including ALI, were determined. Kaplan–Meier and Cox regression analyses were used to determine each factor’s prognostic value. Results The median OS was 31 months. The optimal cutoff value for ALI was 41.20. Patients with high ALI (≥41.20) displayed increased OS (33.87 vs. 30.24 months), higher survival rates, and milder clinical characteristics. Univariate and multivariate analyses showed a significant correlation between ALI and the prognosis of patients with NSCLC, including those at stage IIIA, who underwent VATS. Conclusions Low ALI correlated with poor outcomes in patients with NSCLC following VATS. Preoperative ALI might be a potential prognostic biomarker for patients with NSCLC following VATS, including patients at stage IIIA.