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Abstract Background To explore the effects of monitoring measurable residual disease and post‐remission treatment selection on the clinical outcomes of B‐cell acute lymphoblastic leukemia (B‐ALL) in adults. Methods Between September 2010 and January 2022, adult patients with B‐ALL who received combination chemotherapy, with or without allogeneic hematopoietic stem cell transplantation (allo‐HSCT), were included in the retrospective study, which was approved by the Ethics Committee and the observation of Declaration of Helsinki conditions. Results One hundred and forty‐three B‐ALL patients achieved complete remission (CR) were included in the study, of whom 94 patients (65.7%) received allo‐HSCT in first complete remission (CR1). Multivariate analysis showed that the most powerful factors affecting OS were transplantation (hazard ratio [HR] = 0.540, p = 0.037) and sustained measurable residue disease (MRD) negativity (HR = 0.508, p = 0.037). The subgroup analysis showed that the prognosis of the allo‐HSCT group was better than that of the chemotherapy group, regardless of whether MRD was negative or positive after two courses of consolidation therapy. After consolidation therapy, the prognosis of patients with positive MRD remained significantly better in the allo‐HSCT group than in the chemotherapy group. However, no significant difference was observed in the prognosis between the allo‐HSCT and chemotherapy groups with negative MRD after consolidation therapy. Conclusions B‐ALL patients who achieve sustained MRD negativity during consolidation therapy have excellent long‐term outcomes even without allo‐HSCT. Allo‐HSCT is associated with a significant benefit in terms of OS and DFS for patients who were with positive MRD during consolidation therapy.

Abstract Genetic heterogeneity poses a great challenge to the understanding and management of acute myeloid leukemia (AML). Knowledge of the IKZF1 mutation in AML specifically is extremely limited. In a previous work, we described the distribution pattern of IKZF1 mutation in AML, but its clinical impact has remained undefined due to the limited number of cases. Herein, we attempt to answer this question in one relatively large cohort covering 522 newly diagnosed AML patients. A total of 26 IKZF1 mutations were found in 20 AML patients (20/522, 3.83%). This condition has a young median age of onset of morbidity (P = 0.032). The baseline characteristics of IKZF1-mutated and wild-type patients were comparable. IKZF1 mutation showed significant co-occurrences with CEBPA (P 0.20) showed relatively short overall survival period (P = 0.012), and it was an independent factor for the increased risk of death (hazard ratio, 6.101; 95% CI 2.278–16.335; P = 0.0003). In subgroup analysis, our results showed that IKZF1 mutation conferred poor therapeutic response and prognosis for SF3B1-mutated AML (P = 0.0017). We believe this work improves our knowledge of IKZF1 mutation.

Hematotoxicity is the most common long-term adverse event after chimeric antigen receptor T cell (CAR-T) therapy. Here, a total of 71 patients with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL) or large B-cell lymphoma (LBCL) were used to develop an early hematotoxicity predictive model and verify the accuracy of this model. The incidences of early hematotoxicity at 3 month following CAR-T infusion in B-ALL and LBCL were 45.5% and 38.5%, respectively. Multivariate analyses revealed that the severity of cytokine release syndrome (CRS) was an independent risk factor affecting early hematotoxicity. The analysis between the peak cytokine levels and early hematotoxicity suggested that tumor necrosis factor-α (TNF-α) and C-reactive protein (CRP) were closely associated with early hematotoxicity. Then, an early predictive model of hematotoxicity was constructed based on the peak contents of TNF-α and CRP. This model could diagnose early hematotoxicity with positive predictive values of 87.7% and 85.0% in training and validation cohorts, respectively. Lastly, we constructed the nomogram for clinical practice to predict the risk of early hematotoxicity, which performed well compared with the observed probability. This early predictive model is instrumental in the risk stratification of CAR-T recipients with hematotoxicity and early intervention for high-risk patients.

Abstract Background The nucleoporin 98 (NUP98)-paired related homeobox 1 (PMX1) fusion gene, which results from t(1;11)(q23;p15), is rare in patients with acute myeloid leukemia (AML). Currently, only two cases of chronic myeloid leukemia in the accelerated phase or blast crisis and three cases of therapy-related AML have been reported. Here, we first report a patient with de novo AML carrying the NUP98-PMX1 fusion gene. Case presentation A 49-year-old man diagnosed with AML presented the karyotype 46,XY,t(1;11)(q23;p15)[20] in bone marrow (BM) cells. Fluorescence in situ hybridization analysis using dual-color break-apart probes showed the typical signal pattern. Reverse transcription-polymerase chain reaction (RT-PCR) analysis suggested the presence of the NUP98-PMX1 fusion transcript. The patient received idarubicin and cytarabine as induction chemotherapy. After 3 weeks, the BM aspirate showed complete remission, and the RT-PCR result for the NUP98-PMX1 fusion gene was negative. Subsequently, the patient received three cycles of high-dose Ara-c as consolidation chemotherapy, after which he underwent partially matched (human leukocyte antigen–DP locus mismatch) unrelated allogeneic hematopoietic stem cell transplantation (HSCT). The follow-up period ended on September 30, 2020 (6 months after HSCT), and the patient exhibited no recurrence or transplantation-related complications. Conclusion This is the first report of a patient with de novo AML carrying the NUP98-PMX1 fusion gene. The reported case may contribute to a more comprehensive profile of the NUP98-PMX1 rearrangement, but mechanistic studies are warranted to fully understand the role of this fusion gene in leukemia pathogenesis.

Background: Colorectal cancer (CRC) has not only seriously affected people’s lives, but also burdened the government healthcare system. Long non-coding RNAs (lncRNA) have attracted more and more attention in the cancer study field. Methods: Experiments were completed in the Medical Research and Innovation Center of Shanghai Pudong Hospital, China from 2019 to 2020. Cell cycle was detected by western blot analyzing and flow cytometry. Apoptosis analysis were determined using flow cytometry or western blot analysis. LncRNA CKMT2-AS1 was knocked down by shRNA transfection. Results: We found CKMT2-AS1 was the most significant=0.0105 for SW480 and P=0.0071 for HCT116) difference lncRNA between colorectal cancer treated with autophagy inducer and colorectal cancer without any treatment. Effective shRNA-CKMT2-AS1 was also designed. Following, we found the treatment of autophagy inducer and autophagy inducer + shRNA-NC were able to suppress the proliferation of both SW480 and HCT116 cells. In addition, the treatment of autophagy inducer + shRNA-CKMT2-AS1 significantly reduced the apoptosis of SW480 and HCT116 cells induced by autophagy. Furthermore, we found the phosphorylation of mTOR, AKT was enhanced in SW480, and HCT116 cells treated with autophagy inducer + shRNA-CKMT2-AS1 compared to the cells treated with autophagy inducer of autophagy inducer + shRNA-NC. Conclusion: Enhancing the expression of CKMT2-AS1 will become a promising strategy to prevent the progress of colorectal cancer.

Background: COVID-19 has taken a huge toll on medical resources and the economy and will inevitably have an impact on public mental health. Post-traumatic stress disorder (PTSD), as the most common mental illness after an epidemic, must be seriously addressed. This study aimed to investigate the subjective fear of the Chinese general public during COVID-19 and to explore how it affected the development of PTSD.Methods: An online questionnaire survey was conducted among 1,009 people from January 30 to February 14, 2020 (about 1 month after the COVID-19 outbreak). The subjective fear was measured by a self-reported single-choice question. Four items from the Pittsburgh Sleep Quality Index (PSQI) were selected to measure the subjects' sleep quality. Their post-traumatic stress symptoms (PTSS) were measured by the PTSD Checklist for DSM-5 (PCL-5). Pearson correlation, hierarchical multivariate regression analysis, multiple mediator model, and bootstrapping were used in statistical analyses.Results: Different people showed different levels of subjective fear in response to the outbreak. There was a significant positive correlation between subjective fear and the total score of PCL-5 (R = 0.513, P < 0.01), meaning that the higher the degree of subjective fear, the more severe the symptoms of post-traumatic stress are. Subjective fear was an important predictor of PTSS, accounting for 24.3% of the variance. The total effect of subjective fear on PCL-5 scores was significant (total effect = 7.426, SE = 0.405, 95% CI = 6.631–8.221). The total indirect effect of subjective fear on PCL-5 scores through sleep quality was also significant (total indirect effect = 1.945, SE = 0.258, 95% CI = 1.436–2.470).Conclusions: Subjective fear has an important predictive effect on PTSS. In addition to the direct effect, our findings firstly demonstrate the mediating role of sleep quality in the relationship between subjective fear and PTSS.

Background Biphenotypic acute leukemia is a rare disorder that is difficult to diagnose. It displays features of both myeloid and lymphoid lineage. There is still a lack of studies in biphenotypic acute leukemia in a Chinese population. We present here a comprehensive investigation of the clinical and biological characteristics, and outcome of biphenotypic acute leukemia in our hospital in over a seven year period.Design and Methods We retrospectively analyzed 452 adult acute leukemia patients diagnosed according to French-American-British (FAB) classification and biphenotypic acute leukemia diagnosed according to European Group for the Immunological Characterization of Leukemias (EGIL) classification, respectively. Biological characteristics, response to treatment, and outcome were examined in biphenotypic acute leukemia patients and compared with that in acute myeloid leukemia and acute lymphoblastic leukemia patients with complete follow-up profiles diagnosed in the same period.Results Of 452 acute leukemia patients, 21 cases (4.6%) were diagnosed as biphenotypic acute leukemia. Among them, 14 (66.7%) were B lymphoid and myeloid, 5 (23.8%) were T lymphoid and myeloid, one (4.8%) was T/B lymphoid and one (4.8%) was trilineage differentiation. When compared with acute myeloid leukemia and acute lymphoblastic leukemia, patients with biphenotypic acute leukemia showed significantly higher incidence of CD34 antigen expression, unfavorable karyotypes, and extramedullary infiltration (p

Tungsten is a very important refractory metal in the fields of nuclear fusion demonstration reactor, spallation neutron source, and semiconductor. The expected properties of tungsten plates can be obtained by rolling and deforming. The DEFORM software was used to simulate the rolling of tungsten plates in large size in this paper, and the influence of rolling mode on damage factor (damage value) and strain was analyzed. The results show that, the serious damage area for one-way rolling is mainly distributed at the side edge of the billets, which is easy to produce cracks; the serious damage area for cross rolling is uniformly distributed around the billets. The strain curves of cross rolling in the rolling direction may reach a “maximum value” and then descend to a “minimum value”, and the difference of strain between the two maximum value is smaller in cross rolling than that in one-way rolling.

NiCrAlY alloy powders used for the thermal spraying were fabricated by the closed-coupled gas atomization technology. The physical properties, particle size distribution, powder morphology, internal microstructure, and phase composition of the NiCrAlY alloy powders were investigated. The results show that, most of powders are spherical or nearly spherical particles, the particle size of 85% powders is less than 150 μm. The powder microstructures are mainly composed of dendrites and cellular crystals, and the solidification cooling rate of the powders with the particle size of 25～250 μm is about 4000～67000 K·s−1. The inner structure of the powders with the particle size less than 50 μm is dense, and a small number of particles with the particle size larger than 50 μm show the solidification shrinkage pore and hollow defects. There are Y and Si segregation in the crystal boundary and intracrystalline, and the powder phases are mainly composed of γ'-Ni3Al and γ-Ni solid solution phases.

Tungsten (W) and tungsten alloy coatings were prepared by plasma spraying on 45# steel and TC4 titanium alloys. Ablation tests were carried out under the different ablation conditions. The ablation resistance of the coatings was compared, and the ablation failure mechanism of the coatings was discussed. The results show that, the ablation resistance of the base materials is improved by spraying W coatings. When the ablation temperature is 2600 ℃ for 11 s, the coatings are oxidized, and there is no ablation phenomenon. When the ablation temperature is 3400 ℃ for 6 s, the coatings have the obvious ablation, indicating that the heat is transferred to the matrix, resulting in the matrix temperature exceeding the own melting point. The W+Al2O3 and W+ZrO2 composite coatings slow down the heat transfer rate from the coating surface to the substrate, and improve the ablative resistance of the substrate materials. The dynamometer curves of W+Al2O3 and W+ZrO2 composite coatings show the zigzag decline and do not resist the erosion, but the coating ablative resistance time is relatively long.

Background and objective Xuanwei and Fuyuan are rural counties, located in the late Permian coal poly area of eastern Yunnan and western Guizhou, where lung cancer mortality rates are among the highest in the China, with similarity for both men and women, younger age at diagnosis and death, and higher in rural areas than in urban areas. In this paper, long-term follow-up of lung cancer cases in local peasants was conducted to observe their survival prognosis and its influencing factors. Methods Data of patients diagnosed with lung cancer from January 2005 to June 2011, who had lived in Xuanwei and Fuyuan counties for many years, were collected from 20 hospitals at the local provincial, municipal and county levels. To estimate survival outcomes, individuals were followed up until the end of 2021. The 5-year, 10-year and 15-year survival rates were estimated using the Kaplan-Meier method. Survival differences were examined with Kaplan-Meier curves and Cox proportional hazards models. Results A total of 3,017 cases were effectively followed up (2,537 peasants and 480 non-peasants). The median age at diagnosis was 57 years, and the median follow-up time was 122 months. During the follow-up period, 2,493 cases (82.6%) died. The distribution of cases by clinical stage was as follows: stage I (3.7%), stage II (6.7%), stage III (15.8%), stage IV (21.1%) and unknown stage (52.7%). Treatment at the provincial, municipal and county-level hospitals accounted for 32.5%, 22.2% and 45.3%, respectively, and surgical treatment was performed in 23.3% of cases. The median survival time was 15.4 months (95%CI: 13.9-16.1), and the 5-year, 10-year and 15-year overall survival rates were 19.5% (95%CI: 18.0%-21.1%), 7.7% (95%CI: 6.5%-8.8%) and 2.0% (95%CI: 0.8%-3.9%), respectively. Peasants with lung cancer had a lower median age at diagnosis, higher proportion residing in remote rural areas, and higher use of bituminous coal as a household fuel. They also have a lower proportion of early-stage cases, treatment at provincial or municipal hospitals, and surgical treatment, leading to poorer survival outcomes (HR=1.57). Even when considering factors such as gender, age, residential location, clinical stage at diagnosis, histological type, hospital level of service, and surgical intervention, peasants still exhibit a survival disadvantage. Multivariable Cox model analysis comparing peasants and non-peasants reveals that surgical intervention, tumor-node-metastasis (TNM) stage, and hospital level of service are common factors influencing survival prognosis, while the use of bituminous coal as a household fuel, hospital level of service and adenocarcinoma (compared to squamous cell carcinoma) are independent prognostic factors for lung cancer survival among peasants. Conclusion The lower lung cancer survival rate among peasants is associated with their lower socioeconomic status, lower proportion of early-stage diagnoses, lower proportion of surgical interventions, and treatment at provincial-level hospitals. Furthermore, the impact of other factors such as high-risk exposure to bituminous coal pollution on survival prognosis requires further investigation.

Mo–30Cu alloy billets were prepared by powder metallurgy infiltration method, the rolled Mo–30Cu billets and oxygen-free copper plates were hot-pressed at 970 ℃ with a pressure of 30 MPa to obtain 5-layer Cu/MoCu/Cu (CPC) composites. The effects of the Mo–30Cu surface treatments on the interface bonding strength of the multi-layer CPC composites were studied by the microstructure observation, ultrasonic scanning analysis, high-temperature thermal examination, and air leakage rate testing. The results show that, the multi-layer CPC composites prepared by Mo–30Cu interlayer materials treated by wiredrawing have no cavity defects after being heated at 830 ℃ for 10 min, and the leakage rate is less than 5×10−3 Pa·cm3·s−1. The multi-layer CPC composites prepared by Mo–30Cu interlayer materials treated by grinding show the bulging phenomenon after the thermal examination, have the obvious cavity defects in the interior, and the leakage rate is greater than 5×10−3 Pa·cm3·s−1.

[Introduction] To solve the problem of difficult site selection for grounding electrodes in HVDC transmission projects in Guangdong, this paper analyzes the connection of existing grounding electrodes to form a WAN grounding electrode for future DC project access to reduce the impact on electrical facilities and underground metal piping facilities around the electrode site. [Method] The feasibility of forming a wide-area grounding electrode by using existing grounding electrodes as sub-grounding electrodes was analyzed, several typical application scenarios of WAN grounding electrodes were proposed, and the natural shunted current calculation, current distribution averaging and multiple DC simultaneous operation conditions of each sub-grounding electrode were carried out. [Result] WAN grounding electrode can reduce the design requirements of Yuedong pole site and mitigate the impact of Yulongling grounding electrode on oil and gas pipeline and surrounding power system, and has the feasibility of implementation. However, the benefits are still not obvious without adding any current averaging resistors. [Conclusion] This study provides ideas and methods to reduce the difficulty of constructing new grounding electrodes by using WAN grounding electrodes.

Tungsten rhenium alloy is widely used in aerospace, weapon electronics, and other high-temperature fields. W25Re alloy bars were prepared by powder metallurgy combined with the rolling deformation process. The mechanical properties of W25Re alloy were studied. The results show that rolled W25Re alloy bars have excellent mechanical properties. The tensile strength at room temperature is up to 1650 MPa and the elongation is 15%. As temperature increases, the tensile strength of W25Re alloy decreases rapidly, and the elongation first increases and then decreases. However, at 2000 °C, the tensile strength of more than 200 MPa and elongation of 16% can still be maintained. The fracture morphology shows that the dimples disappear and dynamic recrystallization occurs at 1600 °C and that the grain grows further at 2000 °C. The analysis shows that with increasing temperature, the increasing grain size and decreasing grain adhesion lead to decreasing strength and plasticity at 2000 °C.

This paper analyzes and compares the four mainstream cloud desktop technologies: RDS, VDI, IDV and VOI. According to the practical application in colleges and universities, a hybrid cloud desktop technology scheme is designed and proposed, and the specific implementation method of the integration of VDI and VOI is studied. In view of the particularity and requirements of experimental courses and application scenarios, an application model based on this technical scheme is designed, which is suitable for all the common scenes of computer experimental teaching, realizes the deep integration of cloud desktop and teaching activities, and also provides reference for the construction and application of cloud desktop technology in colleges and universities.

In view of the problems existing in the current teaching of computer network technology and application course, this paper introduces the educational concept driven by innovative thinking into the teaching of the course, and puts forward specific teaching reform measures: the teaching method which adopts the engineering application of innovative thinking as the guidance and focuses the problems on the core knowledge points, combining MOOC, SPOC and flipped classroom teaching philosophy, it is student-centered and arouses students’ interest in learning. Practice has proved that the teaching reform has obvious practical effects: students can quickly grasp the basic theory of computer network with more goals, and meanwhile, their practical ability, teamwork ability and innovation ability can be better trained and improved, which is conducive to the cultivation of high-quality innovative talents.

Abstract Objectives Uniportal video-assisted thoracoscopic surgery pneumonectomy (U-VATS-P) is feasible and safe from a perioperative standpoint. How to choose the proper chest tube and drainage method is important in enhanced recovery after surgery (ERAS) protocols. In this study, we aimed to assess the safety of one 8.5-Fr (1Fr = 0.333 mm) pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. Methods We retrospectively reviewed a single surgeon’s experience with U-VATS-P for lung cancer from May 2016 to September 2022. Patients were managed with one 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage after U-VATS-P. The clinical characteristics and perioperative outcomes of the patients were retrospectively analyzed. Results In total, 77 patients had one 8.5-Fr pigtail catheter placed for postoperative continuous open gravity drainage after U-VATS-P for lung cancer. The mean age was 60.9 $$\pm$$ 7.39 (40–76) years; The mean FEV1 was 2.1 $$\pm$$ 0.6 (l/s), and the mean FEV1% was 71.2 $$\pm$$ 22.7. The median operative time was 191.38 $$\pm$$ 59.32 min; the mean operative hemorrhage was 109.46 $$\pm$$ 96.56 ml; the mean duration of postoperative chest tube drainage was 6.80 $$\pm$$ 2.33 days; the mean drainage volumes in the first three days after operation were 186.31 $$\pm$$ 50.97, 321.97 $$\pm$$ 52.03, and 216.44 $$\pm$$ 35.67 ml, respectively; and the mean postoperative hospital stay was 7.90 $$\pm$$ 2.58 days. No patient experienced complications resulting from chest tube malfunction. Ten patients experienced minor complications. One patient with nonlife-threatening empyema and bronchopleural fistula required short rehospitalization for anti-inflammatory therapy and reintubation. Three patients with chylothorax were treated with intravenous nutrition. Four patients had atrial fibrillation that was controlled by antiarrhythmic therapy. Two patients had more thoracic hemorrhagic exudation after the operation, which was found in time and was cured effectively, so they were discharged from the hospital uneventfully after early hemostatic therapy and nutritional support. Conclusions All patients in this study received early postoperative rehabilitation, and the rate of relevant complications was low. We therefore recommend a single 8.5-Fr pigtail catheter for postoperative continuous open gravity drainage as an effective, safe and reliable drainage method for the management of U-VATS-P.

Abstract Background Mutations of the glucocerebrosidase (GBA) gene have reportedly been associated with Parkinson disease (PD) in various ethnic populations such as Singaporean, Japanese, Formosan, Canadian, American, Portuguese, Greek, Brazilian, British, Italian, Ashkenazi Jewish, southern and southwestern Chinese. The purpose of this study is to determine in central China whether or not the reported GBA mutations remain associated with PD. Methods In this project, we conducted a controlled study in a cohort of 208 central Chinese PD patients and 298 controls for three known GBA mutations (L444P, N370S and R120W). Results Our data reveals a significantly higher frequency of L444P mutation in GBA gene of PD cases (3.4%) compared with the controls (0.3%) (P = 0.007, OR = 10.34, 95% CI = 1.26 - 84.71). Specifically, the frequency of L444P mutation was higher in the late onset PD (LOPD) cases compared with that in control subjects. The N370S and R120W mutations were detected in neither the PD group nor the control subjects. Conclusions Our observations demonstrated that the GBA L444P mutation confers genetic risk for PD, especially LOPD, among the population in the central China area.

Abstract Background Levetiracetam (LEV) is an antiepileptic drug with a favorable tolerability and safety profile with little or no effect on liver function. Case presentation Here, we reported an epileptic pediatric patient who developed a significant elevation in serum alkaline phosphatase level (ALP) during LEV monotherapy. Moreover, the serum ALP level was surprisingly decreased to normal after LEV discontinuation. The Naranjo Adverse Drug Reaction Probability Scale score was 6, indicating firstly LEV was a probable cause for the increased serum ALP. Conclusions Cautious usage and concerns of the LEV-associated potential ALP elevation should be considered when levetiracetam is prescribed to epilepsy patients, especially pediatric patients.

Abstract Background Cerebral venous sinus thrombosis (CVST) is a relatively rare cerebrovascular condition which accounts for 0.5% of all strokes. Risk of CVST has been documented in patients with numerous conditions including central nervous system infections, however, Japanese encephalitis (JE, epidemic encephalitis type B) with CVST has not been reported previously. Case Presentation Here, we present a case of JE with CVST in a 17-year-old man. On admission, the patient was initially diagnosed as intracranial infection, and soon after, brain magnetic resonance (MR) imaging (MRI) and MR Venography (MRV) confirmed the diagnosis of CVST. Moreover, the blood JE-specific IgM antibody which proved weakly positive at first, turned positive one week later. Consequently, our patient was diagnosed as CVST accompanied by JE. Anticoagulant and anti-infective therapy were initiated, which eventually lead to gradual recovery of the patient. Conclusions To our knowledge, this is the first case report of CVST associated with JE. MRI and MRV represent a prime method for the diagnosis of CVST, while the positivity of JE virus IgM antibody, especially increased antibody levels within a short period, is of great significance to diagnose JE. The early diagnosis and timely treatment of this potentially lethal condition would improve its prognosis significantly.

Abstract Background With the advantages of better cosmetic incision and faster recovery, uniportal video-assisted thoracoscopic surgery (UP-VATS) has developed rapidly worldwide in recent decades, and indications for UP-VATS have been further expanded to those for conventional VATS. Complex segmentectomy that makes several or intricate intersegmental planes, with more complex procedures, continues to be difficult in minimally invasive techniques. However, there are few reports on UP-VATS complex segmentectomy. In this report, we describe the perioperative clinical data and operative techniques and present our early results of UP-VATS complex segmentectomy in our hospital. Methods The records of a total of 30 patients who underwent UP-VATS complex segmentectomy by a single surgeon between January 2021 and June 2021 were retrospectively reviewed. We defined cases as complex segmentectomy if they required resection of segments 9 and 10, combined segmentectomy, segmentectomy + subsegmentectomy, subsegmentectomy, or combined subsegmentectomy. Results The mean age was 52.8 ± 9.9 years old; the mean nodule size was 0.84 ± 0.36 cm; the mean margin width was 2.307 ± 0.309 cm; the median operative time was 229.0 ± 58.06 min; the mean operative hemorrhage was 56.60 ± 17.95 mL; 5.58 ± 1.74 lymph nodes dissected had not metastasized; the mean duration of postoperative chest tube drainage was 4.7 ± 1.4 days; and the mean postoperative hospital stay was 6.5 ± 3.0 days. Although 1 patient experienced a prolonged air leak, the other 29 recovered uneventfully. Another patient failed to reach the 2-cm safe margins and subsequently underwent completion lobectomy. Conclusions UP-VATS complex segmentectomy is a safe and effective procedure in the treatment of lung cancers, sparing more pulmonary parenchyma and ensuring safe margins, with the disadvantage being the lengthy operative times during early skill acquisition.

OBJECTIVE To evaluate the efficacy of rituximab combined with CHOP-like regimen with or without IFN in patients newly diagnosed diffuse large B-cell Non-Hodgkin’s lymphoma (DLBCL). METHODS From January 2003 to July 2008, 51 patients received CHOP-like chemotherapy (cyclophosphamide 750 mg/m2, epirubicin 80 mg/m2, vindesine 2.8 mg/m2 on day 1 , and prednisolone 100 mg/day on day 1 to day 5). Thirty- tne patients received CHOPR-like treatment (rituximab 375 mg/m2 1 day before CHOP-like chemotherapy). Twenty patients received CHOP-like regimen in combination with peginterferon (pegIFN) (1 μg/kg on day 5) and rituximab (on day 6). RESULTS The CR (complete remission) rate in the CHOPR-like (with or without pegIFN) group and in the CHOP-like group was 78.4% and 45.1% (P = 0.005), respectively. The estimated mean time of overall survival (OS) in the CHOPR-like group and CHOP-like group was 58.7 ± 2.8 and 36.4 ± 3.4 months, respectively (P = 0.002). The rates of CR and OR (overall remission) in CHOPR-like with IFN arm were 85.0% and 95.0%, and the rates of those in CHOPR-like without IFN arm were 74.2% and 87.0% (P > 0.05). The estimated mean time of 4-year-PFS (progression-free survival) in CHOPR-like with IFN arm and in CHOPR-like without IFN arm was 62.9 ± 3.0 months and 51.0 ± 4.6 months (P = 0.092), respectively. In the CHOPR-like with IFN arm, no patient relapsed after achieving CR, while the estimated rate of 4-year-DFS (disease-free survival) in the patients who reached CR in the CHOPR-like without IFN arm was (63.4 ± 19.3)% (P = 0.061). CONCLUSION Rituximab combined with CHOP-like chemotherapy improved the prognosis of DLBCL patients. The IFN may help to improve the quality and duration of response of DLBCL patients treated with rituximab and CHOP-like regimen.