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ObjectiveThe aim of this study was to identify the risk factors for postoperative adverse events in children with duplex kidney undergoing upper pole heminephrectomy.MethodsWe collected clinical data from pediatric patients with duplex kidney who underwent upper pole heminephrectomy. Based on the presence or absence of postoperative adverse events, the patients were divided into two groups: an adverse events group (n = 16) and a non- adverse events group (n = 37), using multivariate logistic regression analysis to screen for independent risk factors for postoperative adverse events.ResultsThrough univariate and multivariate analysis, we found that the presence of upper renal ureterocele (P = 0.042, OR = 7.116, 95% CI 1.073–47.172), as well as the presence of accessory renal artery type (P = 0.016, OR = 10.639, 95% CI 1.551–72.978) and other types (P = 0.039, OR = 3.644, 95% CI 0.351–37.836) as the upper kidney's blood supply artery increase the risk of postoperative adverse events, with these differences being statistically significant.ConclusionsIn pediatric patients with duplex kidney undergoing upper pole heminephrectomy, the presence of upper renal ureterocele and the presence of accessory renal artery type and other types as the upper kidney's blood supply artery are independent risk factors for postoperative adverse events.

BackgroundRelatively little is known about the effect of traditional Chinese medicine (TCM) on prognosis of non-small cell lung cancer (NSCLC).MethodsIn this nationwide, multicenter, prospective, cohort study, eligible patients aged 18-75 years with radical resection, and histologically confirmed stage II-IIIA NSCLC were enrolled. All patients received 4 cycles of standard adjuvant chemotherapy. Patients who received Chinese herbal decoction and (or) oral Chinese patent medicine for a cumulative period of not less than 6 months were defined as TCM group, otherwise they were considered as control group. The primary endpoint was DFS calculated using the Kaplan–Meier method. A time-dependent Cox proportional hazards model was used to correct immortal time bias. The secondary endpoints included DFS in patients of different characteristics, and safety analyses. This study was registered with the Chinese Clinical Trial Registry (ChiCTR1800015776).ResultsA total of 507 patients were included (230 patients in the TCM group; 277 patients in the control group). The median follow-up was 32.1 months. 101 (44%) in the TCM group and 186 (67%) in the control group had disease relapse. The median DFS was not reached in the TCM group and was 19.4 months (95% CI, 14.2 to 24.6) in the control group. The adjusted time-dependent HR was 0.61 (95% CI, 0.47 to 0.78), equalling to a 39% reduction in the risk of disease recurrence with TCM. the number needed to treat to prevent one patient from relapsing was 4.29 (95% CI, 3.15 to 6.73) at 5 years. Similar results were observed in most of subgroups. Patients had a significant improvement in white blood cell decrease, nausea, decreased appetite, diarrhea, pain, and fatigue in the TCM group.ConclusionTCM may improves DFS and has a better tolerability profile in patients with stage II-IIIA NSCLC receiving standard chemotherapy after complete resection compared with those receiving standard chemotherapy alone. Further studies are warranted.

Background and objective Bronchopulmonary carcinoid (BPC) is a rare neuroendocrine tumor, the clinical studies on treatment and prognostic factors of BPC are somewhat controversial. Our purpose was to evaluate the clinical efficacy of surgery on BPC, and to analyze the prognostic factors affecting the survival of BPC. Methods We retrospectively collected the clinical data of patients with BPC admitted to the Chinese PLA General Hospital between January 2000 and December 2017. The Kaplan-Meier method was used to calculate the survival rate of patients and to map the survival curve. Then the effects of different factors like pathological classification, gender, age, on prognosis were compared by univariate analysis and multivariate analysis was made by Cox proportional hazard model. Results A total of 98 patients had a diagnosis of BPC were included in the study. There were 41 patients with typical carcinoid (TC) and 57 patients with atypical carcinoid (AC). The 1-yr, 5-yr, and 10-yr overall survival rates of BPC were 96.9%, 80.0% and 73.6%, respectively. Univariate analysis showed age (P=0.000,1), smoking history (P=0.005), pathological subtype (P

Background and objective Localization of pulmonary ground glass small nodule is the technical difficulty of minimally invasive operation resection. The aim of this study is to evaluate the value of intraoperative computed tomography (CT)-guided localization using a hook-wire system for small ground glass opacity (GGO) in minimally invasive resection, as well as to discuss the necessity and feasibility of surgical resection of small GGOs (

Background and objective Lung cancer presenting as cystic lesions was first described by Anderson and Pierce in 1954. Lung cancer presenting as cysts is a rare entity in clinical practice. Differential diagnosis is difficult in the benign-like cyst. This study investigated the clinical characteristics, diagnosis and treatment of lung cancer presenting as cysts. Methods We conducted a retrospective analysis of the clinical records of 24 patients who underwent surgery for a primary lung cancer presenting as cysts in our department between 2007 and 2013. We defined a ‘Thin-walled cyst’ as a cavitary lesion with a wall thickness of 4 mm or less along at least 75% of the circumference of the lesion. The whole group underwent post-operative follow-up. Results The incidence of cystic lung cancer was 0.49% (24/4,897) of surgical cases. The subjects’ age ranged from 19 to 77 yr with a median age of 56.5 yr. Ten cases presented with respiratory symptoms while 14 showed abnormal shadows on a chest CT without symptoms. Histological analysis showed that 18 cases were of adenocarcinoma, three of squamous cell carcinoma, one of small cell carcinoma, one of adenosquamous carcinoma and one of large cell carcinoma. Three patients were dead, and the remaining 21 patients are alive and disease free at the end of follow-up. Conclusion Cystic lung cancer should be kept in mind during the differential diagnosis of focal benign cyst. Cystic lung cancer could achieve a good outcome if early diagnose can be obtained.

Background and objective It has been proven that biomarkers play a key role in the individualized treatment of lung cancer. Correlations between expressions of TUBB3/STMN1 and gene mutations of epidermal growth factor receptor (EGFR), Kirsten rat sarcoma viral oncogene homolog (KRAS), v-raf murine sarcoma viral oncogene homolog B (BRAF), phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K) in non-small cell lung cancer (NSCLC) would be investigated and this may provide essential significance on prognosis and predictions of drug efficiency. Methods This study total enrolled 46 NSCLC patients. Tumor specimens were resected. The gene expressions of TUBB3, STMN1 were analyzed using branched DNA-liquidchip, and EGFR, KRAS, BRAF, PI3K gene mutations were detected by xTAG-liquidchip. Correlations between gene expressions and gene mutations were further analyzed by Spearman. Results Co-expressions between TUBB3 and STMN1 are strongly demonstrated, and high expression of TUBB3 always exists as well as high expression of STMN1 (P=0.006). Meanwhile mutation of EGFR E21 is negatively correlated with TUBB3, and wild type of EGFR E21 always exists toghther with high expression of TUBB3 (P=0.004,6), whereas mutation of KRAS E2 is positively associated with expression level of STMN1 (P=0.038,6). Conclusion Antimicrotubule drug resistance factors of TUBB3 and STMN1 may be related with mutations of EGFR signal pathway, suggesting that EGFR mutation and KRAS mutation may be important factors in regulation of TUBB3/STMN1 expression, which provided basic references for chemotherapeutic resistance.

Background and objective Community is quickly turning into the aging period, and lung cancer has become more common in elderly patients with malignant tumor. At present, surgery remains the preferred therapeutic choice. However, it’s worth noting that arrhythmia is a common complication during the perioperative period. The aim of this study is to explore the risk factors of arrhythmia in lung cancer patients over the age of 70 years at perioperative periods. Methods We retrospectively analyzed 352 patients who underwent lobectomy or pneumectomy in Chinese PLA General Hospital from July 1997 to May 2008. χ2 and Logistic regression were performed to analyze the clinical data. Results Among 352 elderly patients with lung cancer, 71 cases accurred perioperative arrhythmias. The occurrence rate was 20.2%. The results of multivariate analysis showed that age, cardiovascular disease history, arrhythmia history, cardiac and pulmonary dysfunction before operation, pneumonectomy, operation time were the high risk factors of perioperative arrhythmia. Conclusion More attention should be paid to prevent perioperative arrhythmia in the eldly lung cancer patients.

Background and objective It is common recognized that young patients of lung cancer have poor prognosis due to relatively higher malignancy and more invasive growth. In the past most studies on young patients of lung cancer selected patients younger than 40 or 45 years old, and there were few clinical materials for younger patients under 30 years. This study retrospectively described the the disease history, stage, treatment and pathology features of lung cancer patients younger than 30 years and aimed to provide references for these patients. Methods Those patients younger than 30 years, once admitted in the General Hospital of the People's Liberation Army for lung cancer from 1993 to date, were sought in medical record system, and 53 patients were found in total. In this group, there were 34 non-small cell lung cancer (NSCLC) patients and 19 small cell lung cacer (SCLC) patients. The male/female ratio was 1.5:1. In the NSCLC patients, there were 27 adenocarcinomas, 6 squamous carcinomas and 1 adenosquamous carcinoma, with no large cell carcinoma involved. In these patients, 12 patients received operations while 38 patients got chemo- and/or radiotherapy and 3 quited any treatment. Results There was no death in hospital, however, in the 12 patients who got operation, only 8 patients got complete resection while 4 patients got palliative resection. Conclusion Lung cancer patients younger than 30 years had a high fraction of adenocarcinoma and small cell type pathologically and most of them were in late stage when presenting with symptoms in hospital and would have a dismal prognosis. The routine health examination and early diagnosis should be emphasized to improve the prognosis of these patients.

Background and objective Video-assisted thoracoscopic surgery (VATS) has been widely used in the diagnosis and treatment of chest diseases, The aim of this study was to explore the feasibility and clinical value of lobectomy with single utility port complete VATS. Methods From September 2009 to December 2009, 21 cases underwent lobectomy with single utility port complete VATS. Of 21 patients, right upper lobectomy was 12 cases, left lower lobectomy 5 cases, right lower lobectomy 2 cases, left upper lobectomy 1 case, right middle lobectomy 1 case. Results The operation process were smooth in all patients and without conversion to thoracotomy. The mean operative time was (132.7±16.2)min and the mean intraoperative blood loss was (110.5±24.6)mL. The average chest tube drainage time was (3.1±1.3)d, and the mean hospitalization day was (5.2±3.2)d. All patients recovered smoothly and without severe complications. There were no post-operative deaths. Conclusion Lobectomy with single utility port VATS is technically feasible and has the advantages of minimal invasive and rapid recovery.

Background The aim of this study was to analyze our experience with management of intrathoracic anastomotic leak after esophagectomy. Methods Clinical data from 33 patients who developed intrathoracic anastomotic leak were evaluated retrospectively. These patients were selected from 1867 patients undergoing resection carcinoma of the esophagus and reconstruction between January 2003 and December 2012. Results Surgical intervention and the reformed "three-tube method" were applied in 13 and 20 patients, respectively. The overall incidence of intrathoracic anastomotic leakage was 1.8%. The median time interval from esophagectomy to diagnosis of leak was 9.7 days. Sixteen patients were confirmed as having leakage by oral contrast computed tomography (CT). Age and interval from surgery to diagnosis of leak were identified as statistically significant parameters between contained and uncontained groups. Moreover, patients with hypoalbuminemia had a longer time to leak closure than patients without hypoalbuminemia. Six patients died from intrathoracic anastomotic leak, with a mortality rate of 18.2%. There was no statistically significant difference in the time to leak closure between patients who underwent surgical exploration and those who received conservative treatment. Conclusions Intrathoracic anastomotic leak after esophagectomy was associated with significant mortality. Once intrathoracic anastomotic leakage following esophagectomy was diagnosed or highly suspected, individualized management strategies should be implemented according to the size of the leak, extent of the abscess, and status of the patient. In the majority of patients with anastomotic leak, we preferred the strategy of conservative treatment. [ABSTRACT FROM AUTHOR]

MicroRNAs (miRNAs) have essential roles in carcinogenesis and tumor progression. Here, we investigated the roles and mechanisms of miR-143 in non-small cell lung cancer (NSCLC). miR-143 was significantly decreased in NSCLC tissues and cell lines. Overexpression of miR-143 suppressed NSCLC cell proliferation, induced apoptosis, and inhibited migration and invasion in vitro. Integrated analysis identified LIM domain kinase 1 (Limk1) as a direct and functional target of miR-143. Overexpression of Limk1 attenuated the tumor suppressive effects of miR-143 in NSCLC cells. Moreover, miR-143 was inversely correlated with Limk1 expression in NSCLC tissues. Together, our results highlight the significance of miR-143 and Limk1 in the development and progression of NSCLC. [ABSTRACT FROM AUTHOR]

Personalized medicine has become essential in the treatment of lung cancer. However, the lung cancer-related gene expression profiles in non-small cell lung cancer (NSCLC) patients have not been elucidated. In this study, the correlation between gene expression profiles and clinicopathological characteristics was investigated in NSCLC patients. A total of 95 patients were enrolled in this study. The mRNA expression levels of 14 genes were assessed by multiplex branched DNA liquidchip (MBL) technology and data on 9 clinicopathological characteristics of patients were collected simultaneously. The correlation between gene expression and clinicopathological characteristics was investigated. Out of the 9 clinicopathological parameters, 6 were associated with several of the 14 genes analyzed. Patient gender was associated with TYMS and TOP2A. Clinical stage was associated with VEGFR2, KIT and HER2. There was weak correlation between primary tumor size of ≤3 cm and the expression level of KIT. The mRNA expression levels of VEGFR2 and HER2 correlated with distant metastasis. BRCA1, TYMS, TOP2A and HER2 were associated with histological type. Smoking correlated with higher expression levels of BRCA1, TYMS and TOP2A and lower expression levels of PDGFRβ. The results were suggestive of correlation between the clinicopathological parameters of the NSCLC patients and the mRNA expression levels of certain lung cancer-related genes, including BRCA1, TYMS, TOP2A, PDGFRβ, VEGFR2, KIT and HER2. [ABSTRACT FROM AUTHOR]

Background: Solitary fibrous tumor of the pleura (SFTP) represents a clinical entity rarely encountered, especially in giant forms. Complete surgical resection for giant tumor of pleura is a challenge. The aim of this article is to present five new cases of giant SFTP, and to discuss their clinical characteristics and the treatment strategy of such neoplasms. Methods: We performed a retrospective review of the clinical records of five patients who underwent surgery for a huge SFTP (>18 cm in diameter) between 2007 and 2009. Results: Four patients were symptomatic. All five patients underwent angiography and embolization of the tumor-supplying vessels within 24 h of surgery. All giant tumors were removed completely by extended postlateral thoracotomy with moderate intraoperative bleeding . Two wedge resections and one lobectomy were performed in three cases where the parenchyma had been encroached. Tumors in three patients were pathologically benign; those in the other two were malignant. The symptoms disappeared in all cases after surgery. Conclusions: Complete resection remains the mainstay of cure for giant SFTP. We recommend preoperative angiography and embolization for giant SFTP which can reduce the risk of hemorrhage and can contribute to piecemeal removal for radical excision. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the leading cause of cancer deaths worldwide, compounded by late diagnosis. MicroRNAs (miRNA) are recently discovered short, noncoding genes that play essential roles in tissue differentiation during normal development and tumorigenesis. miRNA profiles across all histologic grades can provide a reliable and standardized method for the identification of lung cancer. Methods: A microRNA lung cancer dataset was analyzed. Differentially expressed microRNAs were obtained post-normalization of data using t-test (p < 0.01). The data for differentially expressed microRNAs were processed using K-nearest neighbors classification method to obtain unique miRNAs expression patterns. The predicted mRNA targets were identified using TargetScan and the molecular functions associated with the predicted targets were retrieved from the Gene Ontology Consortium and represented using GO IDs in a directed acyclic graph. Results: The results indicate that lung cancer samples can be classified using a small panel of 19 unique microRNAs (8 down-regulated and 11 up-regulated) with over 85% classification accuracy. Furthermore, using classical enrichment analysis, this study identified 66 molecular function groups which are potentially the functional signaling pathways altered by these differentially expressed microRNAs. Conclusions: We identified a microRNA gene signature representative of functioning as a diagnostic biomarker for lung cancer. These findings can potentially form the basis for the development of a standardized diagnostic assay that can be used for early diagnosis of lung cancer equally well from resection specimens and cytology samples. [ABSTRACT FROM AUTHOR]

This study aimed to retrospectively summarize the clinical signs, diagnosis, and treatment of congenital bronchial atresia (CBA) in 12 patients. Chest radiographs and computed tomographic (CT) images of 12 patients with CBA treated in the Chinese People's Liberation Army General Hospital were reviewed. Analysis of chest radiographs revealed ten patients had hilar mass-like shadows and two had pneumonia-like shadows; most patients (n = 8) showed hyperlucency of the peripheral lung fields. CT revealed a mucocele in all the patients (n = 12); the mucoceles were round in four patients and club-like in eight. In 80% of the cases (n = 10), associated anomalies, including occlusions of the bronchus central to the mucocele, emphysematous changes of the peripheral lung fields, bronchogenic cyst, and anomalous branching of the bronchial tree and vascular structure were observed. CBA was detected in the right lobe in eight patients and the left lobe in the remaining four. No surgical intervention was performed in 5 CBA patients and the remaining 7 patients underwent surgery, including lobectomy in 5 patients and local resection in 2 patients. Among these 7 patients, 3 had a preoperative diagnosis of malignant disease, and the remaining 4 had severe clinical symptoms that could not be effectively treated by medicines. All patients were followed up, and none experienced obvious discomfort. CBA is a relatively rare and benign malformation disease. Chest CT is the procedure of choice for diagnosis. The presence of a bronchocele and surrounding emphysematous changes are typical radiologic findings in CBA. Surgery should be reserved only for patients with serious complications secondary to the atretic bronchus.