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BackgroundPterygium is a complex ocular surface disease characterized by the abnormal proliferation and growth of conjunctival and fibrovascular tissues at the corneal-scleral margin. Understanding the underlying molecular mechanisms of pterygium is crucial for developing effective diagnostic and therapeutic strategies.MethodsTo elucidate the molecular mechanisms of pterygium, we conducted a differential gene expression analysis between pterygium and normal conjunctival tissues using high-throughput RNA sequencing. We identified differentially expressed genes (DEGs) with statistical significance (adjust p < 0.05, |logFC| > 1). Enrichment analyses were performed to assess the biological processes and signaling pathways associated with these DEGs. Additionally, we utilized weighted correlation network analysis (WGCNA) to select module genes and applied Random Forest (RF) and Support Vector Machine (SVM) algorithms to identify pivotal feature genes influencing pterygium progression. The diagnostic potential of these genes was validated using external datasets (GSE2513 and GSE51995). Immune cell infiltration analysis was conducted using CIBERSORT to compare immune cell populations between pterygium and normal conjunctival tissues. Quantitative PCR (qPCR) was used to confirm the expression levels of the identified feature genes. Furthermore, we identified key miRNAs and candidate drugs targeting these feature genes.ResultsA total of 718 DEGs were identified in pterygium tissues compared to normal conjunctival tissues, with 254 genes showing upregulated expression and 464 genes exhibiting downregulated expression. Enrichment analyses revealed that these DEGs were significantly associated with inflammatory processes and key signaling pathways, notably leukocyte migration and IL-17 signaling. Using WGCNA, RF, and SVM, we identified KRT10 and NGEF as pivotal feature genes influencing pterygium progression. The diagnostic potential of these genes was validated using external datasets. Immune cell infiltration analysis demonstrated significant differences in immune cell populations between pterygium and normal conjunctival tissues, with an increased presence of M1 macrophages and resting dendritic cells in pterygium samples. qPCR analysis confirmed the elevated expression of KRT10 and NGEF in pterygium tissues.ConclusionOur findings emphasize the importance of gene expression profiling in unraveling the pathogenesis of pterygium. The identification of pivotal feature gene KRT10 and NGEF provide valuable insights into the molecular mechanisms underlying pterygium progression.

Background The systemic inflammatory response index (SIRI), served as a novel inflammatory biomarker, is the synthesis of neutrophils, monocytes and lymphocytes.Aims We hypothesized that SIRI has predictive value for contrast-associated acute kidney injury (CA-AKI) and long-term mortality in patients undergoing elective percutaneous coronary intervention (PCI).Methods We retrospectively observed 5685 patients undergoing elective PCI from January 2012 to December 2018. Venous blood samples were collected to obtain the experimental data on the day of admission or the morning of the next day. SIRI = neutrophil count × monocyte count/lymphocyte count. CA-AKI was defined as an increase of 50% or 0.3 mg/dl in SCr from baseline within 48 h after contrast exposure.Results The incidence of CA-AKI was 6.1% (n = 352). The best cutoff value of SIRI for predicting CA-AKI was 1.39, with a sensitivity of 52.3% and a specificity of 67.3%. [AUC: 0.620, 95% confidence interval (CI): 0.590–0.651, p 1.39) was a strong independent predictor of CA-AKI in patients undergoing elective PCI compared with the low SIRI group (SIRI ≤ 1.39) (odds ratio = 1.642, 95% CI: 1.274–2.116, p 1.39 was significantly associated with long-term mortality at a median follow-up of 2.8 years. [Hazard ratio (HR)=1.448, 95%CI: 1.188–1.765; p

Introduction: Hepatic steatosis is a hepatic pathological change closely associated with metabolic disorders, commonly observed in various metabolic diseases such as metabolic syndrome (MetS), with a high global prevalence. Dai-Zong-Fang (DZF), a traditional Chinese herbal formula, is widely used in clinical treatment for MetS, exhibiting multifaceted effects in reducing obesity and regulating blood glucose and lipids. This study aims to explore the mechanism by which DZF modulates the gut microbiota and reduces hepatic steatosis based on the gut-liver axis.Methods: This study utilized db/db mice as a disease model for drug intervention. Body weight and fasting blood glucose were monitored. Serum lipid and transaminase levels were measured. Insulin tolerance test was conducted to assess insulin sensitivity. Hematoxylin and eosin (HE) staining was employed to observe morphological changes in the liver and intestine. The degree of hepatic steatosis was evaluated through Oil Red O staining and hepatic lipid determination. Changes in gut microbiota were assessed using 16S rRNA gene sequencing. Serum lipopolysaccharide (LPS) levels were measured by ELISA. The expression levels of intestinal tight junction proteins, intestinal lipid absorption-related proteins, and key proteins in hepatic lipid metabolism were examined through Western blot and RT-qPCR.Results: After DZF intervention, there was a decrease in body weight, alleviation of glucose and lipid metabolism disorders, reduction in serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, and mitigation of insulin resistance in mice. DZF significantly modulated the diversity of the gut microbiota, with a notable increase in the abundance of the Bacteroidetes phylum. PICRUSt indicated that DZF influenced various functions in gut microbiota, including carbohydrate and amino acid metabolism. Following DZF intervention, serum LPS levels decreased, intestinal pathological damage was reduced, and the expression of intestinal tight junction protein occludin was increased, while the expression of intestinal lipid absorption-related proteins cluster of differentiation 36 (CD36) and apolipoprotein B48 (ApoB48) were decreased. In the liver, DZF intervention resulted in a reduction in hepatic steatosis and lipid droplets, accompanied by a decrease fatty acid synthase (FASN) and stearoyl-CoA desaturase 1 (SCD1) and fatty acid transport protein 2 (FATP2). Conversely, there was an increase in the expression of the fatty acid oxidation-related enzyme carnitine palmitoyltransferase-1𝛂 (CPT-1𝛂).Conclusion: DZF can regulate the structure and function of the intestinal microbiota in db/db mice. This ameliorates intestinal barrier damage and the detrimental effects of endotoxemia on hepatic metabolism. DZF not only inhibits intestinal lipid absorption but also improves hepatic lipid metabolism from various aspects, including de novo lipogenesis, fatty acid uptake, and fatty acid oxidation. This suggests that DZF may act on the liver and intestine as target organs, exerting its effects by improving the intestinal microbiota and related barrier and lipid absorption functions, ultimately ameliorating hepatic steatosis and enhancing overall glucose and lipid metabolism.

Introduction: The global prevalence of obesity is rising rapidly. Conversion of white adipose tissue (WAT) into beige adipose tissue with heat-consuming characteristics, i.e., WAT browning, effectively inhibits obesity. Dai-Zong-Fang (DZF), a traditional Chinese medicine formula, has long been used to treat metabolic syndrome and obesity. This study aimed to explore the pharmacological mechanism of DZF against obesity.Methods:In vivo, C57BL/6J mice were fed high-fat diets to establish the diet-induced obese (DIO) model. DZF (0.40 g/kg and 0.20 g/kg) and metformin (0.15 g/kg, positive control drug) were used as intervention drugs for six weeks, respectively. The effects of DZF on body size, blood glucose and lipid level, structure and morphology of adipocytes and browning of inguinal WAT (iWAT) in DIO mice were observed. In vitro, mature 3T3-L1 adipocytes were used as the model. Concentrations of DZF (0.8 mg/mL and 0.4 mg/mL) were selected according to the Cell Counting Kit-8 (CCK8). After 2d intervention, lipid droplet morphology was observed by BODIPY493/503 staining, and mitochondria number was observed by mito-tracker Green staining. H-89 dihydrochloride, a PKA inhibitor, was used to observe the change in browning markers′ expression. The expression levels of browning markers UCP1 and PGC-1α and key molecules of PKA pathway were detected in vivo and in vitro.Results:In vivo, compared with vehicle control group, 0.40 g/kg DZF significantly reduced obesity in DIO mice from body weight, abdomen circumference, Lee′s index, and WAT/body weight (p < 0.01 or p < 0.001). 0.40 g/kg DZF also significantly reduced fasting blood glucose (FBG), serum triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) (p < 0.01 or p < 0.001). The iWAT′s morphology and mitochondria were browning after DZF intervention. In HE-staining, the lipid droplets became smaller, and the number of mitochondria increased. The mitochondrial structure was remodeled under the electron microscope. The expression of UCP1, PGC-1α and PKA was elevated in iWAT detected by RT-qPCR (p < 0.05 or p < 0.001). In vitro, compared with the control group, 0.8 mg/mL DZF intervention significantly increased the number of mitochondria and expression of UCP1, PGC-1α, PKA, and pCREB (p < 0.05 or p < 0.01). In contrast, UCP1 and PGC-1α expression were significantly reversed after adding PKA inhibitor H-89 dihydrochloride.Conclusion: DZF can promote UCP1 expression by activating the PKA pathway, thereby promoting browning of WAT, attenuating obesity, and reducing obesity-related glucose and lipid metabolism abnormalities, indicating that DZF has the potential to be selected as an anti-obesity drug to benefit obese patients.

AIM: To explore the multimodal imaging features of butterfly-like retinal pigment epithelial dystrophy(BPD)patients.METHODS: Retrospective analysis of the multimodal imaging of 18 BPD patients(36 eyes)from January 2016 to July 2019, including fundus color photography, infrared photography, autofluorescence, fundus fluorescein angiography, indocyanine green angiography, optical coherence tomography(OCT), and optical coherence tomography angiography(OCTA). RESULTS: A typical fundus color photography showed the appearance of a butterfly-like lesion caused by abnormal pigmentation. The appearance of the butterfly was not obvious after the lesion progressed, and the corresponding region shrinks; Infrared photography showed the yellow lesions clearly in the BPD patients, which are white highlight images; Autofluorescence showed patchy, spotted butterfly wing performance. When the lesion progressed, autofluorescence did not show typical butterfly changes, but it showed the damage of pigment epithelial cells; Fundus fluorescein angiography and choroidal angiography, in addition to showed butterfly lesions, can more accurately display vascular lesions, especially choroidal neovascularization(CNV); OCT showed lesions located between the retinal pigment epithelial(RPE)layer and the photoreceptors. As the lesion progressed, the pigment epithelium showed enlarged lesions correspondingly. Secondary CNV patients can be seen to break RPE; OCTA showed that the lesions were not obvious at the deep and superficial layers of the retina. But the choroidal blood flow signals were lost in some degrees in OCTA, and the blood flow images of CNV can be detected sensitively.CONCLUTION: Multimode imaging technology can provide imaging features of progression in BPD patients, which helps clinicians to understand the disease more deeply.

Familial exudative vitreoretinopathy(FEVR)is a severe clinically and genetically heterogeneous retinal disease which characterized by abnormal development of the peripheral retinal vessels. FEVR presents many clinical phenotypes, the main and typical feature is retinal folds. There are various inheritance modes with high genetic heterogeneity of FEVR including autosomal recessive, X-recessive, autosomal dominant recessive, and other scattered inheritance modes. So far, nine FEVR pathogenic genes have been reported: NDP, FZD4, LRP5, CTNNA1, TSPAN12, ZNF408, KIF11, CTNNB1, and JAG1 genes. These genes are mainly involved in signaling pathways such as Wnt, Notch, and Norrin-β-catenin. This article reviews the above nine FEVR pathogenic genes and their signaling pathways.

Background Shrunken pore syndrome (SPS) as a novel phenotype of renal dysfunction is characterized by a difference in renal filtration between cystatin C and creatinine. The manifestation of SPS was defined as a cystatin C–based estimated glomerular filtration rate (eGFR)

Forsythiae Fructus (FF), the fruit of Forsythia suspensa (Thunb.) Vahl. (Lianqiao), is one of the most fundamental herbs in Traditional Chinese Medicines (TCM), mainly due to its heat-clearing and detoxifying effects. There are two types of FF, the greenish fruits that start to ripen (GF) and the yellow fruits that are fully ripe (RF), called “Qingqiao” and “Laoqiao” referred to the Chinese Pharmacopoeia, respectively. It undergoes a complex series of changes during the maturation of FF. However, the clinical uses and preparation of phytopharmaceuticals of FF have not been distinguished to date. Moreover, there is limited information on the study of the difference in pharmacological activity between RF and GF. In this study, a rat model of bile duct ligation (BDL)-induced cholestasis was used to compare the differences in their effects. RF was found to have better results than GF in addressing toxic bile acids (BAs) accumulation and related pathological conditions caused by BDL. The underlying mechanism may be related to the interventions of gut microbiota. The results of the present study suggest that the better detoxifying effect of RF than GF may be indirectly exerted through the regulation of gut microbiota and thus the improvement of BAs metabolism.

AIM: To study the effect of monocular form deprivation(MD)on the synaptic density in the visual cortex of the amblyopic rats during the critical period of visual development, the visual cortical synaptophysin(SYN)expression and significance of its expression, as well as the relationship between the synaptic density and the visual function. This research will provide mechanisms underlying the pathogenesis and clinical treatment of amblyopia.METHODS: Normal newborn Long Evans rats were randomly divided into normal control group and amblyopia model group, each with 16 rats. Both groups of rats were raised in the same environment. The normal control group did not receive any treatment. On the 13d after birth, the amblyopic model group received monocular suture to establish a classic monocular form deprived amblyopic model. Both groups of rats were received Visual evoked potential(F-VEP)detection on the 51d. Samples were taken immediately after the detection. The transmission electron microscope and Image J image analysis software were used to observe and analyse the synaptic density in the V1M of the primary visual cortex of the two groups of rats. Frozen sections of visual cortex were stained by immunofluorescence histochemical staining by bleaching method and the expression of SYN positive neurons was observed and quantitatively analyzed. RESULTS: F-VEP examination showed that compared with the normal control group, the P2 latency of the deprived eyes in the amblyopic group was significantly long, and the amplitude of P2 wave was significantly lower than that of normal eyes(P

Aflatoxin B1 (AFB1), a mycotoxin contaminating food and feed, can trigger liver immune toxicity and threaten the poultry industry. Phillygenin (PHI) is a natural lignan derived primarily from Forsythia suspensa with hepatoprotective pharmacological and medicinal properties. This research aimed to investigate the preventive effects of PHI on the toxicity of AFB1 in the liver of chickens. Chickens were administered with AFB1 (2.8 mg/kg) and/or treated with PHI (24 mg/kg) for 33 days. The histopathological changes, serum biochemical indices, oxidative damage, inflammatory mediators, apoptosis, and activation of the NF-κB and Nrf2 signaling pathways were measured. Results revealed that dietary PHI ameliorated liver function indicators, reduced the malondialdehyde and inflammatory mediator production and the apoptotic cell number, and increased the antioxidant enzyme contents and Bcl-2 level. The quantitative realtime PCR and Western blot results revealed that PHI reduced p53, cytochrome c, Bax, caspase-9, and caspase-3 levels, normalized the NF-κB p65 phosphorylation, and upregulated the Nrf2 and its downstream genes expression in chicken liver. These results indicated that PHI has beneficial effects on AFB1-induced liver damage, oxidative damage, inflammatory response, apoptosis, and immunotoxicity by inhibiting NF-κB and activating the Nrf2 signaling pathway in chickens. This study provides new insight into the therapeutic uses of PHI.

OBJECTIVE: Hybrid debranching technique combined with conventional open surgery and endovascular repair was an effective treatment for thoracoabdominal aortic aneurysm (TAAA). We propose a new technique to reduce the time of RA anastomosis. MATERIALS AND METHODS: The hybrid staged operation procedure was evaluated in the period of 2013 and 2017 in three academic centers. The bilateral renal artery anastomosis in the experimental group used VORTEC technique. In the control group, the bilateral renal artery reconstruction was performed by conventional artificial blood vessel anastomosis. Primary outcome was technical success, the time of renal artery anastomosis, and major complications. Long term follow-up up to 7 years was evaluated as well. RESULTS: In total 57 patients were enrolled. Compared with the control group, there was a statistical difference in the mean time of left RA anastomosing (19.8 vs 4.6 min, p

Objective Preliminary study on the protective effect of intraoperative direct electrical stimulation motor ⁃ evoked potential (DES ⁃ MEP) on motor function during brainstem tumor surgery. Methods Total 136 patients with brainstem tumor surgery from January 2017 to May 2020 were enrolled, including 68 patients treated with intraoperative routine electrophysiological monitoring combined with neuronavigation and 68 patients with DES ⁃ MEP combined with neuronavigation on the basis of routine electrophysiological monitoring. According to the changes of muscle strength (Lovett Muscle Strength Classification) before and after operation, the patients were judged to have new dyskinesia motor function or not. The true positive, false positive, true negative and false negative were judged by DES ⁃ MEP monitoring and postoperative motor function prognosis. The sensitivity and specificity, positive predictive value and negative predictive value, and accuracy of DES ⁃ MEP monitoring results in predicting postoperative motor function prognosis were calculated. Results Patients undergoing DES⁃MEP combined with routine electrophysiological monitoring had 16.18% (11/68) of severe new dyskinesia (Lovett Muscle Strength Classification reduction ≥ 2 grade) 2 weeks after surgery, which was lower than patients undergoing routine electrophysiological monitoring [32.35% (22/68); χ2 = 4.841, P = 0.028]. There were 44 true positive cases, 4 false positive cases, 7 true negative cases, and 13 false negative cases detected by DES ⁃ MEP. The sensitivity and specificity of DES ⁃ MEP were 77.19% (44/57) and 7/11, the positive predictive value and negative predictive value of DES ⁃ MEP were 91.67% (44/48) and 35% (7/20), and accuracy of DES ⁃ MEP was 75% (51/68), respectively. Conclusions The application of DES ⁃ MEP in brainstem tumor surgery can effectively protect the brainstem motor function and make up for the deficiency of intraoperative neural monitoring technology in the protection of brainstem corticospinal tract function. DOI:10.3969/j.issn.1672⁃6731.2020.11.004

Human brain bank is the foundation for neurology and neuroscience, which provides research materials for medical scientists to explore what happen in human brains. Through voluntary postmortem brain tissue donation, brain bank collects, classifies, stores and distributes brain tissue samples for researchers with appropriate research proposals, so as to facilitate researchers to conduct human brain research. History showed that the act of brain only autopsy distinguished neurology as a distinct discipline. The emerges of brain banking accompanied with the advances of neurology and neuroscience. It facilitates the development of neurology from neuropathological examination feedback about the clinical presentations of the brain donor, plays an important role in the definition of novel neurological diseases, and also makes an extraordinary contribution to the disease mechanisms and novel therapeutic discoveries. This manuscript elaborated the history, current situation, and the impacts of human brain banking on current neurology. Furthermore, we discussed about the opportunities and challenges of brain banking in China. DOI:10.3969/j.issn.1672⁃6731.2020.10.012

Abstract Background The complement system plays a critical role as the pathogenic factor in the models of acute lung injury due to various causes. Cobra venom factor (CVF) is a commonly used complement research tool. The CVF can cause acute inflammation in the lung by producing complement activation components. Atorvastatin (ATR) is a 3-hydroxy-3-methylglutaryl coenzyme A inhibitor approved for control of plasma cholesterol levels. This inhibitor can reduce the acute pulmonary inflammatory response. However, the ability of ATR in treating acute lung inflammation caused by complement activation is still unknown. Therefore, we investigated the effect of ATR on lung inflammation in mice induced by activation of the complement alternative pathway in this study. Methods ATR (10 mg/kg/day via oral gavage) was administered for 7 days before tail vein injection of CVF (25 μg/kg). On the seventh day, all mice were sacrificed 1 h after injection. The lung lobe, bronchoalveolar lavage fluid (BALF), and blood samples were collected. The myeloperoxidase (MPO) activity of the lung homogenate, the leukocyte cell count, and the protein content of BALF were measured. The levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), P-selectin, and Intercellular cell adhesion molecule-1 (ICAM-1) in BALF and serum were determined by enzyme-linked immunosorbent assay. The pathological change of the lung tissue was observed by hematoxylin and eosin staining. The deposition of C5b-9 in the lung tissue was detected by immunohistochemistry. The phosphorylation of NF-κB p65 in the lung tissues was examined by immunohistochemistry and western blotting. Results The lung inflammation levels were determined by measuring the leukocyte cell numbers and protein content of BALF, the lung MPO activity, and expression and staining of the inflammatory mediators (IL-6 and TNF-α), and adhesion molecules (P-selectin and ICAM-1) for lung lesion. A significant reduction in the lung inflammation levels was observed after 7 days in ATR pre-treated mice with a CVF-induced lung disease. Deposition of C5b-9 was significantly alleviated by ATR pretreatment. Early intervention with ATR significantly reduced the development of acute lung inflammation on the basis of phosphorylation of NF-κB p65 in the lung. Conclusion These findings suggest the identification of ATR treatment for the lung inflammation induced by activating the complement system on the basis of its anti-inflammatory response. Together with the model replicating the complement activating characteristics of acute lung injury, the results may be translatable to the overactivated complement relevant diseases.

Background: Abernethy malformation is an extremely rare anomaly of the splanchnic venous system, and only 2 cases that manifested as syncope had been reported previously.Case Presentation: A 24-year-old male had a 15-year history of jaundice and was in long-term use of hepatoprotective drugs. He was admitted for complaint of syncope. He underwent a series of examinations and cardiac ultrasound showed that his pulmonary artery pressure was elevated. Further imaging revealed the absence of intrahepatic portal veins. His blood ammonia was significantly increased. All signs and symptoms pointed to an Abernethy diagnosis. He was finally diagnosed as having Abernethy type II. He was discharged after 17 days of in-hospital treatment with sildenafil (50 mg/day) and ornithine aspartate (20 g/day).Conclusion: We now report this rare case of syncope that is caused by Abernethy malformation. As a typically pediatric disease, it was not identified in this patient until adulthood due to long-term treatment for jaundice and liver cirrhosis. Furthermore, we present a review of portosystemic shunts previously reported in the literature.

Carotid sinus syndrome is a principal cause of syncope in the elderly. Syncope, associated with carotid sinus syndrome which is secondary to metastasis of advanced nasopharyngeal carcinoma, rarely occurs. The current study reported a 66-year-old woman, who presented with a history of frequent and recurrent syncope as the initial symptom, and was eventually diagnosed with advanced nasopharyngeal carcinoma. The positron emission tomography scan demonstrated a diagnosis of advanced nasopharyngeal carcinoma with involvement in carotid sheath space, and nasopharyngeal biopsy revealed non-keratinized nasopharyngeal carcinoma. After diagnosis and treatment, the patient had no recurrence of syncope. In summary, our case study suggests that great importance should be attached to potential intrinsic causes of syncope especially in the case of nasopharyngeal carcinoma, as it is an insidious malignancy which needs to be precisely identified.

AIM: To investigate the role of reactive oxygen species (ROS) and antioxidant mechanism underlying the metabolic memory of bovine retinal pericytes (BRPs) induced by high glucose. METHODS: Effects of high glucose levels and culture time on BRPs viability were evaluated by CCK-8. BRPs were grown in high-glucose media (30 mmol/L) for 4d followed by culture in normal glucose condition (5.6 mmol/L) for 4d in an experimental group. In contrast, in negative and positive control groups, BRPs were grown in either normal-glucose media or high-glucose media for 8d, respectively. The ROS levels, apoptosis, the expression and activity of manganese superoxide dismutase (MnSOD) in BRPs, as well as the protective effect of adeno-associated viral (AAV)-mediated over expression of MnSOD were determined separately by DCHFA, ELISA and Western blot. RESULTS: Comparing the result of cells apoptosis, activity and protein expression of MnSOD and caspase-3, the cell culture system that exposed in sequence in 30 mmol/L and normal glucose for 4d was demonstrated as a suitable model of metabolic memory. Furthermore, delivery of antioxidant gene MnSOD can decrease BRPs apoptosis, reduce activated caspase-3, and reverse hyperglycemic memory by reducing the ROS of mitochondria. CONCLUSION: Increased ROS levels and decreased MnSOD levels may play important roles in pericyte loss of diabetic retinopathy. BRPs cultured in high glucose for 4d followed by normal glucose for 4d could be an appropriate model of metabolic memory. rAAV-MnSOD gene therapy provides a promising strategy to inhibit this blinding disease.

Single spore isolation is a fundamental approach in plant pathology and mycology to isolate and identify plant fungal pathogens from diseased samples. However, routine single spore isolation procedure is time-consuming and has a high risk of contamination by other microorganisms. In this study, we developed a rapid approach for isolating a single spore of the fungal pathogen, Pyricularia oryzae, from rice blast diseased leaves in the paddy field with low potential of contamination. First, rice blast leaves with single lesions were selected in the paddy field, and a single lesion was cut out and pressed and dragged gently across the surface of water agar. Next, a germinated single spore with a barely visible piece of agar was cut out of water agar with a dissecting needle under a stereomicroscope at approximately 120-fold magnification. Last, the germinated single spore with water agar was transferred onto oatmeal tomato agar for growth and preservation. Based on our experience, a skilled technician or student can successfully isolate single spore from over 150 independent diseased samples with nearly no contaminations in a single working day. This approach is also suitable for isolating single spore from other fungal disease samples that produce abundant aerial conidia.

The purpose of this study was to examine the moderating effects of goal orientations and self-efficacy between competitive cognitive anxiety and motor performance under conditions featuring different levels of ego-threat. Eighty-one (40 females) collegiate-level basketball players (M age = 20.26 years and SD = 2.68) completed Sport Competitive Anxiety Test, Ego Orientation in Sport Questionnaire, and General Self-Efficacy Scale prior to the experiment. Athletes participated in two sessions of free-throw tasks. After the first session, which was under a control condition, participants performed in a free-throw competitive session while being provided opponents’ scores that induced different levels of competitive cognitive anxiety. Performance is defined as the accuracy (%) in two free-throw sessions. A hierarchical multiple regression showed that high level of task-orientation and low level of ego-orientation can buffer the impairment of competitive cognitive anxiety on motor performance. The relationship between competitive cognitive anxiety and motor performance did not vary with self-efficacy. An a repeated-measured analysis of covariance after cluster analysis revealed that a high-task/low-ego profile benefited athletes the most regarding the impairment of competitive cognitive anxiety. Together, ego- and task-orientations and “goal profile” moderate the relationship between competitive cognitive anxiety and motor performance; however, self-efficacy may not serve as a moderator variable in between.

ObjectiveTo investigate the independent risk factors for recurrence in intracranial atypical meningiomas (AMs) treated with gross total resection (GTR) and early external beam radiotherapy (EBRT).MethodsClinical, radiological, and pathological data of intracranial AMs treated with GTR-plus-early-EBRT between January 2008 and July 2016 were reviewed. Immunohistochemical staining for Ki-67 was performed. Kaplan–Meier curves and univariate and multivariate Cox proportional hazards regression analyses were used to explore independent predictors of tumor recurrence. Chi square test was performed to compare variables between subgroups.ResultsForty-six patients with intracranial AMs underwent GTR and early EBRT. Ten (21.7%) recurred and three (6.5%) died during a median follow-up of 76.00 months. Univariate and multivariate Cox analyses revealed that malignant progression (MP) (P = 0.009) was the only independent predictor for recurrence, while Ki-67 was of minor value in this aspect (P = 0.362). MP-AMs had a significantly higher recurrence rate (P = 0.008), a higher proportion of irregularly shaped tumors (P = 0.013) and significantly lower preoperative Karnofsky Performance Scale (KPS) scores (P = 0.040) than primary (Pri) AMs. No significant difference in Ki-67 expression was detected between these subgroups (P = 0.713).ConclusionsMP was significantly correlated with an increased incidence of recurrence in GTR-plus-early-EBRT-treated intracranial AMs. Significantly higher frequencies of tumor relapse and irregularly shaped tumors and lower preoperative KPS scores were observed in MP-AMs compared with Pri-AMs. Ki-67 expression is of minor value in predicting tumor recurrence or distinguishing tumor origins in AMs.

Secondary glioblastomas (sGBM) are derived from previously lower-grade [World Health Organization (WHO) grades II or III] gliomas. Lower-grade benign-behaving gliomas may retain their former grade following recurrence, or may become malignant higher-grade glioblastomas. Prediction of tumor behavior in lower-grade gliomas is critical for individualized glioma therapy. A total of 89 patients were included between January 2000 and January 2019 in the present study to establish a nomogram via univariate and multivariate logistic regression analyses. Nomogram predictive performance was tested in the validation group. We then analyzed 36 O-6-methylguanine-DNA methyltransferase (MGMT) unmethylated lower-grade gliomas from patients seen at West China Hospital of Sichuan University. Survival statistics were calculated with the Kaplan-Meier method. Two clinical factors (molecular diagnosis and WHO grade), five radiological factors (location, cortical involvement, multicentricity, uniformity, and margin enhancement), one biomarker (1p19q codeletion), and a combination of three biomarkers (IDH+/ATRX-/TP53-) were associated with glioma upgrading. Nomograms positive for these prognostic factors had an AUC of 0.880 in the derivation group and 0.857 in the validation group. The calibration and score-stratified survival curves for the derivation group and validation group were good. An operational nomogram was published at https://warrenwrl.shinyapps.io/DynNomapp/. The overall survival of secondary gliomas in the MGMT-unmethylated cohort were influenced independently by the use of temozolomide during the treatment of formerly low-grade gliomas (p=0.00096). Clinical and radiological factors and biomarker-based behavior-oriented nomograms may offer a feasible identification tool for the detection of sGBM precursors. This method may further assist neurosurgeons with the stratification of lower-grade glioma cases and thus the development of better, more individualized treatment plans.

Abstract Background The monoclonal gammopathies are a group of plasma-cell proliferative disorders characterized by the secretion of monoclonal immunoglobulin (M protein or paraprotein). Some rare cases have revealed the specific affinity of paraprotein as autoantibody. Here we report a patient with monoclonal gammopathy of undetermined significance (MGUS) accompanied by a remarkable increase of anticardiolipin antibody (aCL) and an extensively decreased coagulation factor activity, however, without any clinical signs of antiphospholipid syndrome (APS) and bleeding. Results Our further investigation indicated that IgMκ paraprotein of this patient possessed an antibody activity against phospholipids so as to bind to cardiolipin and interfere with coagulation assay in vitro. Conclusions This case might be indicative that an abnormality of coagulation tests, disturbed by IgMκ paraprotein, does not predict a risk of bleeding in this patient.

Abstract Background To systematically review and assess the efficacy and safety of hydroxychloroquine (HCQ) for treating primary Sjogren’s syndrome (pSS). Methods Five electronic databases (Pubmed, EMBASE, Web of science, Ovid, Cochrane Library) were searched for randomized controlled trials and retrospective or prospective studies published in English that reported the effect of HCQ on pSS. The subjective symptoms ( sicca symptoms, fatigue and pain) and the objective indexes (erythrocyte sedimentation rate and Schirmer test) were assessed as main outcome measures. A meta-analysis and descriptive study on the efficacy and safety of HCQ were conducted. The estimate of the effect of HCQ treatment was expressed as a proportion together with 95% confidence interval, and plotted on a forest plot. Results Four trials with totals of 215 SS patients, including two randomized controlled trials, one double blind crossover trial and one retrospective open-label study, were analyzed in this review. For dry mouth and dry eyes, the effectiveness of HCQ treatment was essentially the same as placebo treatment. For fatigue, the effectiveness of HCQ was lower than placebo. The efficacy of HCQ in treating pain associated with pSS was superior to that of the placebo. There was no significant difference between HCQ-treated groups and controls in terms of Schirmer test results, but HCQ could reduce the erythrocyte sedimentation rate compare with placebo. A descriptive safety assessment showed that gastrointestinal adverse effects were the most common adverse effects associated with HCQ. Conclusions This systematic review showed that there is no significant difference between HCQ and placebo in the treatment of dry mouth and dry eye in pSS. Well-designed, randomized, controlled trials are needed to provide higher-quality evidence to confirm our findings, and future studies should focus on some other i n dex or extraglandular measures, such as cutaneous manifestations, to further explore the therapeutic effect of HCQ in pSS.

Background: Several studies were published to assess the association between serum uric acid levels and atrial fibrillation risk, but no consistent results were reported. We performed a meta-analysis to evaluate the evidence of the association between hyperuricemia and atrial fibrillation risk. Material/Methods: Pubmed and Embase databases were searched for prospective cohort studies assessing the association between hyperuricemia and atrial fibrillation risk. Relative risks (RRs) with corresponding 95% confidence intervals (95%CIs) were pooled using random-effect of meta-analysis to assess the risk of atrial fibrillation in individuals with hyperuricemia. Results: Six cohort studies were finally included into the meta-analysis. Meta-analysis of those 6 studies showed that hyperuricemia was significantly associated with increased risk of atrial fibrillation (RR = 1.49, 95%CI 1.24-1.79, P Conclusions: Based on the currently available data, hyperuricemia is associated with increased risk of atrial fibrillation.

Background: Various surgical approaches for the removal of sellar region lesions have previously been described. This study aimed to evaluate the reliability and safety of the frontolateral approach (FLA) to remove sellar region lesions. Methods: We presented a retrospective study of 79 patients with sellar region lesions who were admitted and operated by the FLA approach from August 2011 to August 2015 in Department of Neurosurgery of Beijing Tian Tan Hospital. We classified FLA into three types, compared the FLA types to the areas of lesion invasion, and analyzed operation bleeding volume, gross total resection (GTR) rate, visual outcome, and mortality. Results: Seventy-nine patients were followed up from 2.9 to 50.3 months with a mean follow-up of 20.5 months. There were 42 cases of meningiomas, 25 cases of craniopharyngiomas, and 12 cases of pituitary adenomas. The mean follow-up Karnofsky Performance Scale was 90.4. GTR was achieved in 75 patients (94.9%). Two patients (2.5%) had tumor recurrence. No patients died perioperatively or during short-term follow-up. Three patients (3.8%) with craniopharyngioma died 10, 12, and 23 months, respectively, after surgery. The operative bleeding volume of this study was no more than that of the other approaches in the sellar region (P = 0.783). In this study, 35 patients (44.3%) had visual improvement after surgery, 38 patients (48.1%) remained unchanged, and three patients' visual outcome (3.8%) worsened. Conclusions: FLA was an effective approach in the treatment of sellar region lesions with good preservation of visual function. FLA classification enabled tailored craniotomies for each patient according to the anatomic site of tumor invasion. This study found that FLA had similar outcomes to other surgical approaches of sellar region lesions.

Modern agriculture heavily depends on energy consumption, especially fossil energy, but intensive energy input increases the production cost for producers and results in environmental pollution. Organic agricultural production is considered a more sustainable system, but there is lack of scientific research on the energy consumption between organic and conventional systems in China. The analysis and comparison of energy use between the two systems would help decision-makers to establish economic, effective and efficient agricultural production. Thus, the objectives of the present study are to analyze energy inputs, outputs, energy efficiency, and economic benefits between organic and conventional soybean (Glycine max (L.) Merrill) production. A total of 24 organic farmers and 24 conventional farmers in Jilin Province, China, were chosen for investigation in 2010 production year. Total energy input was 71.55 GJ ha−1 and total energy output was 96.18 GJ ha−1 in the organic system, resulting in an energy efficiency (output/input) of 1.34. Total energy input was 9.37 GJ ha−1 and total energy output was 113.4 GJ ha−1 in the conventional system, resulting in the energy efficiency of 12.1. The huge discrepancy in energy inputs and respective efficiencies lies in the several times higher nutrient inputs in the organic compared to the conventional production system. Finally, the production costs ha−1 were 33% higher, and the net income ha−1 25% lower in the organic compared to the conventional soybean production system. It is recommended to improve fertilizer management in organic production to improve its energetic and economic performance.

Background: The radiochemotherapy regimen concomitantly employing temozolomide (TMZ) chemotherapy and radiotherapy (RT) 4 weeks after surgery, followed by 6 cycles of TMZ is a common treatment for glioblastoma (GBM). However, its median overall survival (OS) is only 14.6 months. This study was to explore the effectiveness and safety of early TMZ chemotherapy between surgery and chemoradiotherapy plus the standard concomitant radiochemotherapy regimen. Methods: A randomized, parallel group, open-label study of 99 newly diagnosed GBM patients was conducted at 10 independent Chinese neurosurgical departments from June 2008 to June 2012. Patients were treated with concomitant radiochemotherapy regimen plus early postsurgical temozolomide (early TMZ group) or standard concomitant radiochemotherapy regimen (control group). Overall response was assessed based on objective tumor assessments, administration of corticosteroid and neurological status test. Hematological, biochemical, laboratory, adverse event (AE), and neurological condition were measured for 24 months of follow-up. The primary efficacy endpoint of this study was overall survival (OS). The secondary endpoint was progression free survival (PFS). Results: The median OS time in the early TMZ group was 17.6 months, compared with 13.2 months in the control group (log-rank test P = 0.021). In addition, the OS rate in the early TMZ group was higher at 6, 12, and 18 months than in the control group, respectively (P < 0.05). The median PFS time was 8.7 months in the early TMZ group and 10.4 months in the control group (log-rank test P = 0.695). AEs occurred in 29 (55.8%) and 31(73.8%) patients respectively in early and control groups, including nausea (15.4% vs. 33.3%), vomiting (7.7% vs. 28.6%), fever (7.7% vs. 11.9%), and headache (3.8% vs. 23.8%). Only 30.8% and 33.3% were drug-related, respectively. Conclusions: Addition of TMZ chemotherapy in the early break of the standard concomitant radiochemotherapy regimen was well tolerated and significantly improved the OS of the GBM patients, compared with standard concomitant radiochemotherapy regimen. However, a larger randomized trial is warranted to verify these results.

Linhe National Meteorological Station, a representative weather station in the Hetao Irrigation District of China, was selected as the research site for the present study. Changes in climatic variables and reference evapotranspiration (ET0) (estimated by the Penman-Monteith method) were detected using Mann-Kendall tests and Sen's slope estimator, respectively. The authors analyzed the relationship between the ET0 change and each climatic variable's change. From 1954 to 2012, the air temperature showed a significant increasing trend, whereas relative humidity and wind speed decreased dramatically. These changes resulted in a slight increase in ET0. The radiative component of total ET0 increased from 50% to 57%, indicating that this component made a greater contribution to the increase in total ET0 than the aerodynamic component, especially during the crop growing season (from April to October). The sensitivity analysis showed that ET0 in Hetao is most sensitive to mean daily air temperature (11.8%), followed by wind speed (−7.3%) and relative humidity (4.8%). Changes in sunshine duration had only a minor effect on ET0 over the past 59 years.

Diabetic retinopathy (DR), a major micro-vascular complication of diabetes, has emerged as a leading cause of visual impairment and blindness among working adults in the worldwide. The pathobiology of DR involves multiple molecular pathways and is characterized chronic neurovascular degeneration. Current approaches to prevent or to treat DR are still far from satisfactory. Therefore, it is important to develop new therapeutic strategies for the prevention and treatment to DR. Pigment epithelium-derived factor (PEDF), a 50-kDa secreted glycoprotein, has been described as a multi-functional protein. Some emerging evidences indicate that PEDF are able to target multiple pathways exerting neurotropic, neuroprotective, anti-angiogenic, antivasopermeability, anti-inflammation, anti-thrombogenic and anti-oxidative effects in DR. In this review, we addressed the functions of PEDF in different pathways, which could lead to potential therapeutics on the treatment to DR.

Image segmentation and image denoising are two important and fundamental topics in the field of image processing. Geometric active contour model based on level set method can deal with the problem of image segmentation, but it does not consider the problem of image denoising. In this paper, a new diffusion equation model for noisy image segmentation is proposed by incorporating some classical diffusion equation denoising models into the segmental process. An assumption about the connection between the image intensity and level set function is given firstly. Some classical denoising models are employed to describe the evolution of level set function secondly. The final nonlinear diffusion equation model for noisy image segmentation is built thirdly. Then image segmentation and image denoising are combined in a united framework. The segmental results can be presented by level set function. Experimental results show that the new model has the advantage of noise resistance and is superior to traditional segmentation model.

Safflower injection is well-known as a traditional Chinese medicine used to improve the blood circulation. In this study, seven safflower injection samples from different companies were evaluated for their in vitro anticoagulant activity by measuring their activated partial thromboplastin time (APTT) and prothrombin time (PT) against human plasma. The screening results suggested that the safflower injections exhibited a significant prolonging influence on APTT (p < 0.05 vs. the control group), but not on prolonging PT (p > 0.05 vs. the control group). The safflower injection was separated into four fractions, and among them, fraction four demonstrated the most anticoagulant activity, with an APTT of 95.4 ± 1.4 s at a concentration of 4.0 μg/μL (p < 0.01 vs. control group). In addition, three active components, p-hydroxybenzaldehyde, p-hydroxy-cinnamic acid, and (8Z)-decaene-4,6-diyne-1-O-β-d-glucopyranoside were isolated from fraction four with Sephadex LH-20 and C18 column chromatography. All three active components showed significant prolonging of APTT (p < 0.05 vs. control group). Among them, p-hydroxy-cinnamic acid exhibited the most activity (p < 0.01 vs. control group). The results indicated that safflower injection strongly affects the intrinsic coagulation system, and we suggest that this might be the mechanism by which the safflower injection activates and promotes blood circulation.

Daidzein, which is scarce in nature, has gained significant attention due to its superior biological activity and bioavailability compared with daidzin. So far, it has been widely used in the medicine and health care products industries. The enzymatic approach for the preparation of daidzein has prevailed, benefitted by its high efficiency and eco-friendly nature. Our present research aimed at providing a preparation method of daidzein by enzymatic hydrolysis of daidzin in a new “green” reaction medium-deep eutectic solvents (DESs). Herein, the DESs were screened via evaluating enzyme activity, enzyme stability and the substrate solubility, and the DES (ChCl/EG 2:1, 30 vol %) was believed to be the most appropriate co-solvent to improve the bioconversion efficiency. Based on the yield of daidzein, response surface methodology (RSM) was employed to model and optimize the reaction parameters. Under these optimum process conditions, the maximum yield of 97.53% was achieved and the purity of daidzein crude product reached more than 70%, which is more efficient than conversions in DESs-free buffer. Importantly, it has been shown that DESs medium could be reused for six batches of the process with a final conversion of above 50%. The results indicated that this procedure could be considered a mild, environmentally friendly, highly efficient approach to the economical production of daidzein, with a simple operation process and without any harmful reagents being involved.

In the crystal structure of the title salt, [Ag(NH3)2]4(C7H6O7S2)2·H2O, the four independent AgI complex cations all lie on special positions of m site symmetry, as do the two independent 2-hydroxy-5-methylbenzene-1,3-disulfonate anions. The AgI cations exist in an almost linear coordination geometry [N—Ag—N = 175.2 (2), 178.08 (16), 175.8 (2) and 178.20 (19)°]. The water molecule is disordered about a mirror plane. Two independent complex cations are linked by an Ag...Ag interaction of 3.3151 (1) Å, furnishing a linear [Ag(NH3)2]n polycationic chain running along b. The free complex cations, polycationic chain and 2-hydroxy-5-methylbenzene-1,3-disulfonate anions interact via N—H...O and O—H...O hydrogen bonds, forming a three-dimensional network.

The MnII atom in the title salt, [Mn(H2O)6](C13H10NO3)2·2H2O, lies on a center of inversion in an octahedron of water molecules. The cations, anions and uncoordinated water molecules are linked by O—H...O and O—H...N hydrogen bonds into a three-dimensional network. The anion is essentially planar, with an r.m.s. deviation of all non-H atoms of 0.068 Å.

Background Haemorrhages of brainstem cavernous malformations (CMs) can lead to neurological deficits, the natural history of which is uncertain. The study aimed to evaluate the neurological outcomes of untreated brainstem CMs and to identify the adverse factors associated with worsened outcomes.Methods From 2009 to 2015, 698 patients (321 women) with brainstem CMs were entered into the prospective cohort after excluding patients lost to follow-up (n=43). All patients were registered, clinical data were collected and scheduled follow-up was performed.Results After a median follow-up of 60.9 months, prospective haemorrhages occurred in 167 patients (23.9%). The mean modified Rankin Scale scores at enrolment and at censoring time were 1.6 and 1.2. Neurological status was improved, unchanged and worsened in 334 (47.9%), 293 (42.0%) and 71 (10.2%) patients, respectively; 233 (33.4%) recovered to normal levels. Lesions crossing the axial midpoint (relative risk (RR) 2.325, p=0.003) and developmental venous anomaly (DVA) (RR 1.776, p=0.036) were independently significantly related to worsened outcomes. The percentage of worsened outcomes was 5.3% (18 of 337) in low-risk patients (neither DVA nor crossing the axial point) and increased to 26.0% (13 of 50) in high-risk patients (with both DVA and crossing the axial point). The percentage of worsened outcomes significantly increased as the number of prospective haemorrhages increased (from 1.5% (8 of 531, if 0 prospective ictus) to 37.5% (48 of 128, if 1 ictus) and 38.5% (15 of 39, if >1 ictus)).Conclusions The neurological outcomes of untreated brainstem CMs were improved/unchanged in majority of patients (89.8%) with a fatality rate of 1.7% in our cohort, which seemed to be favourable. Radiological features significantly predicted worsened outcomes. Our results provide evidence for clinical consultation and individualised treatment. The referral bias of our cohort was underlined.

Objective ‒ The aim of this research was to compile a self-management assessment scale for patients with aortic dissection (AD). The questionnaire is useful in making the patient aware of the need for post-operative care in order to contribute to improving the outcome and quality of life. Methods ‒ The initial version of the “postoperative selfmanagement assessment scale for patients with aortic dissection” was developed using the Delphi expert consultation method based on qualitative research results, consultation of self-management-related literature, reference to the existing self-management scale, and self-efficacy theory, combined with the disease characteristics of AD. By using the convenience sampling method, a total of 201 patients with AD who had undergone surgery were selected as the research participants. The initial version of the scale was used for follow-up investigation, and the scale entries were evaluated and exploratory factor analysis carried out to form the formal version of the “postoperative self-management assessment scale for patients with aortic dissection.” A total of 214 patients with AD after surgery were selected as the research participants. The formal version of the scale was used for follow-up investigation, and its reliability and validity were evaluated. Results ‒ The formal version of the scale had 6 dimensions and 35 entries. The Cronbach’s α coefficient for the total scale was 0.908, the split-half reliability was 0.790, and the test–retest reliability after 2 weeks was 0.471. The content validity index of the total scale was 0.963. Exploratory factor analysis yielded six common factors, and the cumulative contribution rate of variance was 66.303%. Confirmatory factor analysis showed that except for the incremental fit index, Tucker–Lewis index, and comparative fit index >0.85, slightly lower than 0.90, χ2 /df <3, root mean square of approximation <0.08, parsimonious goodness-of-fit index, and parsimonious normed fit index >0.50; all other model fitting requirements were satisfied, indicating that the model fitting was acceptable. Conclusion ‒ We compiled the postoperative self-management assessment scale for patients with AD, which has demonstrated excellent reliability and validity and can be used as a tool to evaluate the postoperative selfmanagement level in patients with aortic dissection. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is the most frequent human malignancy and the principal cause of cancer-related death worldwide. Adenocarcinoma is now the main histologic type, accounting for almost half of all the cases. Lung cancer is the leading cause of cancer-related death in most developed countries. Over the last 50 years, the prevalence of adenocarcinoma has been increasing comparative to other lung cancer subtypes. Objective: To determine Minimally invasive thoracoscopic surgery of lung adenocarcinoma in old age. Methods: A crosssectional study was conducted at Shifa International hospital Islamabad Pakistan, which was performed between April 2020 and January 2022. The total number of patients in our study was 152. The number of Male patients was 62 and female were 90. In 152 consecutive patients who underwent for CT guided biopsy, the needle was used 18 Guage. We diagnosed the Lung adenocarcinoma of all patients on CT scan. The age of all patients was more than 40 years. We took in our study stage (1A) of lung adenocarcinoma, which has further 3 subtypes 1A1,1A2 and 1A3. The size of Stage 1A1 up to 1 cm, Stage 1A2 >1 cm <2cm and stage 1A3 >2cm <3cm. We did for all patients Video-assisted thoracoscopic surgery. The surgeon makes one to five small incisions, each one an about 1 inch in between two ribs. Data was tabulated and analyzed by SPSS. Results: The stage of lung adenocarcinoma 1A1 in male patients were 17 and female were 31. The stage of lung adenocarcinoma 1A2 in male patients were 29 and female were 37. The stage of lung adenocarcinoma 1A3 in male patients were 16 and female were 22. Total male patients were 62 and females were 90. P-value of stages of lung adenocarcinoma in gender was 0.64. The stage of lung adenocarcinoma in the age group of 40-50 years 1A1 were 8, 1A2 were 7 and 1A3 were 2. The total patients with age 40-50 years were 17. The stage of lung adenocarcinoma in the age group of 51-65 years 1A1 were 34, 1A2 were 48 and 1A3 were 19. The total patients with age 51-65 years were 101. The stage of lung adenocarcinoma in the age group of >66 years 1A1 was 6, 1A2 was 11 and 1A3 was 17. The total patients with age >66 years was 34. P-value of stages of lung adenocarcinoma in age group was 0.003. The minimum patient recovery time was 3 weeks and the maximum patient recovery time was 5 weeks. The minimum age group of patient was 43 and the maximum age group of patients was 77. MEAN±SD of age was 59.67±7.85. Conclusion: Video-assisted thoracoscopic surgery (VATS) is a reliable and safe approach for the diagnosis and treatment of lung adenocarcinoma with a low complication rate. Minimally invasive techniques are even more advantageous among the elderly. The patient recovery time from 3 weeks to 5 weeks. The frequency of lung adenocarcinoma is more common in the upper lobe as compare to other lobes. In our study, the prognosis of VATS was better than Open Surgery because the patient's recovery time was less than the open surgery procedure. [ABSTRACT FROM AUTHOR]