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This study aimed to clarify the function of miR-630 on non-small cell lung cancer (NSCLC) cells.Quantitative real-time PCR was utilized to detect the mRNA expression of miR-630 and vimentin (VIM) in NSCLC tissues and cells. The protein expression of VIM, P53, Caspase-3, Bcl-2, Bax and JAK2/STAT3 was evaluated via Western blot. Dual-luciferase reporter assay was applied to evaluate whether VIM is the target gene of miR-630. The migration, invasion, proliferation and apoptosis of NSCLC cells were examined by wound-healing assay, transwell assay, CCK-8 assay, and flow cytometry, respectively.MiR-630 was lowly expressed in NSCLC tissues and cells, while VIM was highly expressed in NSCLC cells. Dual-luciferase reporter assay data validated that miR-630 directly targeted VIM. MiR-630 overexpression inhibited VIM expression, but the inhibition of miR-630 upregulated VIM expression. Besides, miR-630 mimics restrained cell migration, invasion, and proliferation, and promoted NSCLC cell apoptosis. Whereas, VIM overexpression partly attenuated the inhibitory effect of miR-630 on NSCLC cells. Moreover, miR-630 mimics impeded p-JAK2 and p-STAT3 protein expression; and miR-630 inhibitor upregulated p-STAT3 and VIM protein expression, which was reversed after the addition of STAT3 inhibitor C188-9.MiR-630 constrained the progression of NSCLC by inhibiting JAK2/STAT3 pathway and downregulating VIM expression.

Purpose To investigate the features of 18F-Fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in differentiating synchronous multiple primary lung cancers (sMPLC) from intropulmonary metastasis (IM). Material and Methods Fifty-nine patients with two synchronous primary lung cancers were selected and 23 lung cancer patients with an additional solitary IM cancer were chosen as the control group between January 2009 and January 2019. Maximum standardized uptake values (SUVmax) on PET/CT was determined for each tumor. The SUVmax ratio between the two tumors was determined and receiver operating characteristic curve analysis was used to evaluate the diagnostic performance. Results The difference of SUVmax ratio between sMPLC (2.3 ± 1.6) and IM (1.5 ± 0.4) was significant, p Conclusion The SUVmax ratio between two tumors may be helpful in differentiating sMPLC from IM, independent studies with bigger size were needed to further confirm the findings.

Objectives. This study focused on the biological functions and mechanisms of action of LINC01554 in nonsmall cell lung cancer (NSCLC). Methods. The expression and prognostic values of LINC01554 in NSCLC were evaluated using The Cancer Genome Atlas datasets. MTT, colony formation, wound healing, transwell, and in vivo assays were performed to investigate the role of LINC01554 in NSCLC. The related protein expression levels were measured via western blotting. Bioinformatic analysis was conducted to predict targeted genes. The relationship between LINC01554, microRNA- (miR-) 1267, miR-1267, and inhibitor of growth family member 3 (ING3) was analysed via a dual-luciferase reporter assay. Results. LINC01554 expression was downregulated in NSCLC and associated with NSCLC prognosis. LINC01554 overexpression suppressed NSCLC cell proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT). Bioinformatic and dual-luciferase reporter assays demonstrated that LINC01554 expression directly targeted miR-1267 expression, which in turn directly acted on ING3. An miR-1267 mimic significantly reduced ING3 expression, whereas an miR-1267 inhibitor observably elevated its expression. LINC01554 overexpression increased ING3 expression, whereas this effect was counteracted by the miR-1267 mimic. LINC01554 overexpression also significantly suppressed the expression of phosphorylated protein kinase B (Akt) and phosphorylated mammalian target of rapamycin (mTOR) expression; this effect was abrogated by the miR-1267 mimic. Mechanistically, LINC01554 overexpression repressed the growth, migration, invasion, and epithelial-mesenchymal transition (EMT) of NSCLC cells through the regulation of the miR-1267/ING3 axis via regulation of the Akt/mTOR signalling pathway. Conclusions. We provide the first evidence of the involvement of the LINC01554/miR-1267 axis in NSCLC proliferation and metastasis through the ING3Akt/mTOR pathway. Thus, LINC01554 may serve as a novel therapeutic target for NSCLC.

Older people are very likely to experience transitions among spaces with different temperatures in daily life. But little has been known about their thermal comfort and physiological responses to these temperature steps. This study investigated 18 healthy older people's thermal perceptions and physiological parameters under cold and warm exposures with 3/5/6 °C temperature steps. The results showed that subjects' thermal sensation was sensitive to all moderate temperature steps, but their thermal comfort perception could only distinguish temperature changes greater than 5 °C. Thermal unacceptability was only observed when subjects' tympanic temperature reached at 37.08 °C. Also, we found older people need more than 50 min time to get their mean skin temperature steady after cold stimuli, while they only need

Purpose Minimally invasive esophagectomy is increasingly performed for esophageal or gastroesophageal junctional cancer, with advantages of improved perioperative outcomes in comparison with open esophagectomy. McKeown and Ivor Lewis are widely used procedures of minimally invasive esophagectomy, and there have been controversies on which one is preferred for patients with resectable esophageal or junctional cancer. Patients and methods This review was registered at the International Prospective Register of Systematic Reviews (number CRD42017075989). Studies in PubMed, Embase, Web of Science, the Cochrane Library, and ClinicalTrials.gov were thoroughly investigated. Eligible studies included prospective and retrospective studies evaluating short-term outcomes of minimally invasive McKeown esophagectomy (MIME) vs minimally invasive Ivor Lewis esophagectomy (MILE) in patients with resectable esophageal or junctional tumors. Main parameters included anastomotic leak and 30-day/in-hospital mortality. Overall incidence rates (ORs)/weighted mean difference (WMD) with 95% confidence intervals (CIs) were calculated by employing random-effects models. Results Fourteen studies containing 3,468 cases were included in this meta-analysis. Age, male sex, and American Joint Committee on Cancer (AJCC) stage between the 2 groups were not statistically different. MIME led to more blood loss, longer operating time, and longer hospital stay than MILE. MIME was associated with higher incidence of pulmonary complications (OR =1.96, 95% CI =1.28-3.00) as well as total anastomotic leak (OR =2.55, 95% CI =1.40-4.63), stricture (OR =2.07, 95% CI =1.05-4.07), and vocal cord injury/palsy (OR =5.62, 95% CI =3.46-9.14). In addition, the differences of R0 resection rate, number of lymph modes retrieved, blood transfusion rate, length of intensive care unit stay, incidence of cardiac arrhythmia, and Chyle leak between MIME and MILE were not statistically significant. Notably, incidence of severe anastomotic leak (OR =1.28, 95% CI =0.73-2.24) and 30-day/in-hospital mortality (OR =1.76, 95% CI =0.92-3.36) as well as 90-day mortality (OR =2.22, 95% CI =0.71-6.98) between the 2 procedures were also not significantly different. Conclusion This study suggests that MIME and MILE are comparable with respect to clinical safety. MILE may be a better option when oncologically and clinically suitable. MIME is still a safe alternative procedure when clinically indicated. However, this evidence is at risk for bias; randomized controlled trials are needed to validate or correct our results.

Well-designed multi-energy conversion systems have the potential to reduce energy consumption and carbon emissions. Based on the literature review and the typical energy flow network of multi-energy conversion systems, the necessity of stakeholders' taking part in multi-energy projects have been emphasized. Considering of different stakeholders have different interest demand and theirs' decision-making behaviors interact with each other, both the final results and decision process are important for stakeholders in multi-energy system planning. Game analysis, which is an analysis method for the conveying scheme evolution in different situations, was proposed to descript the complex relationship between stakeholders' profits and technical schemes. A hierarchical game playing scheme and a simplified multi-energy system optimization method were put forward to assist stakeholders to participate in techno-economic analysis process. Annual equivalent full capacity operation time and hourly earnings of each energy conversion technology are used to calculate returns on investment. The total revenues and every stakeholders' economic returns in different situations (energy price) and technical proposals can be acquired and compared. The proposed method is also illustrated and verified along with a case study. Results indicated that all parties can make contingent decisions under multi-partner negotiation with the assist of game analysis method.

It has been established that the tumor microenvironment (TME) has a crucial role in enabling tumors to evade from host immune responses. Previous studies demonstrated that tumor cells are not only able to reshape immune milieu at the tumor site, but also exert systemic effects, which has been demonstrated to be important for metastasis. At present, how the peripheral immune environment change in the tumor-bearing host is unclear. The present study identified a number of changes in the proportions of lymphocyte subpopulations and the levels of cytokines in patients with NSCLC, which may provide a preliminary profile of the immune environment in the peripheral blood of patients harboring a tumor. These findings expand on the present knowledge on how tumors can alter the immune system to benefit its growth and metastasis, which may provide a potential novel strategy for immunotherapy.

This paper and its future companion papers, were aimed to develop a set of efficient and accurate enough modular tools to build a simulation test bed for the stability analysis of interacting VAV (variable air volume air-conditioning system) control loops. By providing the correlation equations between the heat flow and temperature of the two opposite surfaces, the wall model was expected to link adjacent zones effectively and efficiently. In part 1, the development of an optimal simplified 3R2C (composed of three resistances and two capacitances) thermal network model of building envelope, i.e., the wall model, was descripted. The verification showed that the simplification of one-dimensional heat conduction through a typical wall of heavy construction was acceptable. The accuracy of the optimal simplified 3R2Cmodel was satisfying, and outperformed that of the optimal 4R3C model as well as two 3R2C models which were normally used in practical applications. First and foremost, the room dimensions of the test bed with the boundary conditions in numerical scheme were designed under the principle of similarity. After validation of the numerical scheme with the high-cited scaled experiment, a series of numerical test cases simulating the potential oscillations in practical applications, were conducted. Then, the long neglected concerned frequency range within which heat flow transfer through extern wall, was determined. Finally, the part of solid wall was separated with the part of indoor air, and was developed into a flexible wall module of 3R2C model based on frequency domain regression.

Investigating the relationship between the performance of an integrated energy system (IES) and each influencing factor as well as directly calculating IES efficiency based on relevant parameters are of substantial importance to energy saving. To make the research results applicable to various IES, a typical integrated energy system (TIES) which includes typical energy conversion technologies is proposed. After building energy demands and energy conversion processes in TIES are abstracted and simplified by a typical energy flow map, a dimensionless equation for calculating TIES energy and exergy efficiency is developed. Based on the partial derivatives analysis of TIES’s energy and exergy efficiency dimensionless equation, the effects of technological level, demand structure, local renewable energy utilization and IES configuration on energy and exergy efficiency are clarified. Combined with a case study, the usability of the parameter analysis method for IES has been illustrated. The departure phenomenon of energetic and exergetic analysis results in IES are also introduced. Furtherly, we indicate that without proper definition of benchmark environment, it is easy to give perplexing results with an exergetic analysis about IES.

Community energy system optimization model has great contribution to formulate community energy planning indexes. But an inappropriate response of uncertainty always makes such “optimal plan” work ended in nothing. It is still a herculean task to solve a hybrid programming model which contains stochastic and fuzzy parameters. In order to acquire more flexible and reliable energy planning indicators in a convenient way, a goal programming based model system (GPMS) is proposed to conduct dynamic variation analysis of community energy flow. GPMS contains general linear programming model, goal programming model and grey relational degree model for results analysis. General linear programming model is used to calculate optimal community energy flow on baseline situation. Deviational variables associated with each independent parameter and total fossil energy consumption (TFEC) are introduced in goal programming model. Many kinds of optimum community secondary energy flow maps can be acquired by adjusting the weight which has been given to TFEC’s deviation variables. The grey correlation degree, a measure of relevancy between two data series, is used to evaluate these optimum community energy flow results. At last, this GPMS for community energy plan is introduced, as well as a case study in Tianjin.

Supplemental Digital Content is available in the text, To shed light on the interaction between the American Joint Committee on Cancer (AJCC) T stage and M stage in the determination of the overall survival (OS) and cancer-specific survival (CSS) of esophageal carcinoma patients. Moreover, to confirm our hypothesis that tumors that metastasize to distant sites in the early T stage may reflect a more biologically aggressive disease compared with those that metastasize in more advanced T stages. We performed a retrospective cohort study with patients who were pathologically diagnosed with esophageal cancer between 2004 and 2014 in the surveillance epidemiology and end results (SEER) database. The primary study variables were the T and M stage, as well as their interaction terms. We performed a survival analysis of the interaction terms using unadjusted Kaplan–Meier methods and adjusted Cox proportional hazards models. Furthermore, we performed an exploratory analysis with stratification by histological type, esophageal adenocarcinoma (EAC), and esophageal squamous cell carcinoma (ESCC). Data of 19,078 patients were retrieved from the SEER database. Unadjusted Kaplan–Meier curve indicated that patients with T2 and T3 stage had longer median OS and CSS (3 months and 4 months, respectively) than with T1 stage in distantly metastatic esophageal cancer (M1 stage). Multivariate analysis revealed a significant interaction between the T stage and M stage when determining the OS and CSS of esophageal cancer (P

Jianqing Deng, Zhipeng Ren, Jiaxin Wen, Bo Wang, Xiaobin Hou, Zhiqiang Xue, Xiangyang Chu Department of Thoracic Surgery, Chinese PLA General Hospital, Beijing, People’s Republic of China Purpose: This study aimed to establish a nomogram to predict the overall survival (OS) of the general non-small-cell lung cancer (NSCLC) patients with distant metastasis. Patients and methods: We investigated Surveillance, Epidemiology, and End Results database for NSCLC patients with distant metastasis diagnosed between 2010 and 2014. Statistically significant prognostic factors were identified using uni- and multivariable Cox regression analyses. A nomogram incorporating these prognostic factors was developed and evaluated by the Harrell’s concordance index (C-index), calibration plots, and risk group stratifications. Results: We finally included 18,209 patients for analysis. These patients were divided into two groups, 14,567 cases for the training cohort and 3,642 for the validation cohort. Marital status, sex, race, age, histology, T stage, N stage, histological differentiation, bone metastasis, brain metastasis, liver metastasis, with M1a disease, surgery of primary cancer, and chemotherapy were identified as the prognostic factors of the OS and integrated to construct the nomogram. The nomogram had a C-index of 0.704 (95% CI: 0.699–0.709) in the training set and 0.699 (95% CI: 0.689–0.709) in the validation set. The calibration curves for 1- and 2-year OS in the training and validation sets showed acceptable agreement between the predicted and observed survival. Also, the nomogram was capable of stratifying patients into different risk groups within the patients who presented with bone, liver, or brain metastasis, as well as in each T, N stage, respectively. Conclusion: A nomogram was established and validated to predict individual prognosis for the general patients with distantly metastatic NSCLC. Global prospective data with the latest TNM classification and more comprehensive prognostic factors are needed to improve this model. Keywords: nomogram, metastatic lung cancer, SEER, prognosis, overall survival, prediction

Peer-reviewed extended abstract submitted to 12i3m, 29-30 September 2018, St. Gallen, Switzerland

Perforation is the most serious complication of esophageal foreign bodies. Studies examining the association between diabetes and esophageal foreign body-induced perforation are largely non-existent.The purpose of this study was to identify the risk factors for esophageal foreign body-induced perforation.A retrospective chart review of patients with esophageal foreign bodies between January 2012-January 2017 was performed at the Chinese People's Liberation Army General Hospital. The patients were divided into two groups: those complicated with perforation and those without perforation. Date on patient demographics, symptoms, foreign bodies, and diabetes were collected and analyzed. Study-specific odds ratio and 95% confidence intervals (CI) were estimated using multivariable logistic regression models.Of 294 patients with esophageal foreign bodies (41.84% male, mean age, 56.73 years), 33 (11.22%) complicated by perforation. Diabetes (odds ratio = 6.00; 95% confidence interval = 1.72-20.23), duration (24 h) of foreign bodies retention (odds ratio = 4.25; 95% confidence interval = 1.71-10.86), and preoperative fever (odds ratio = 8.19; 95% confidence interval = 3.17-21.74) were strongly associated with an increased risk of perforation, whereas the sensation of a foreign body (odds ratio = 0.32; 95% confidence interval = 0.09-0.92) was a protective factor of perforation. Glucose level was not observed to have an association among patients with or without perforation.Diabetes and duration of foreign body retention increase risk for esophageal foreign bodies complicated by perforation, and cases with elevated armpit temperature may represented a more likely perforation compared with those without fever.

Supplemental material, Supplemental tables for Diabetes is an independent risk factor for delayed perforation after foreign bodies impacted in esophagus in adults by Shaowei Zhang, Jiaxin Wen, Mingmei Du, Yunxi Liu, Lianbin Zhang, Xiangyang Chu and Zhiqiang Xue in United European Gastroenterology Journal

Supplemental material for Diabetes is an independent risk factor for delayed perforation after foreign bodies impacted in esophagus in adults by Shaowei Zhang, Jiaxin Wen, Mingmei Du, Yunxi Liu, Lianbin Zhang, Xiangyang Chu and Zhiqiang Xue in United European Gastroenterology Journal

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.

Aim Lung cancer presenting as cysts is a rare entity in clinical practice. Differential diagnosis is difficult in the benign-like cyst. Methods We conducted a retrospective analysis of the clinical records of 15 patients who underwent surgery for primary lung cancer presenting as cysts (wall thickness

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.

Inhibitor of differentiation 4 (Id4) plays an important role in tumorigenesis, but its role in cancer chemoresistance remains unclear. Our study showed that Id4 expression in cisplatin-resistant A549/DDP cells was higher than that in parental A549 cells. Moreover, overexpression of Id4 in A549 cells results in cisplatin resistance and apoptosis inhibition, while increasing the IC50 for cisplatin through activation of phospho-p38 MAPK. However, Id4 knockdown in A549/DDP cells was shown to resensitize A549/DDP cells to cisplatin and induce apoptosis, as well as decrease the IC50 for cisplatin through inactivation of phospho-p38 MAPK. In addition, a p38 MAPK inhibitor (SB202190) could partly reverse both Id4-reduced apoptosis and Id4-induced cisplatin resistance. These results suggest that Id4 inhibits cisplatin-induced apoptosis in human lung adenocarcinoma, partially through activation of the p38 MAPK pathway. Our research indicates that Id4 may be a new target for non-small-cell lung cancer treatment.

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.

We recruited 805 patients with suspicious pulmonary masses that were identified finally as lung cancer or benign pulmonary masses. The serum levels of four tumor markers, including squamous cell carcinoma antigen (SCC), carcinoembryonic antigen (CEA), cytokeratin 19 fragment antigen 21-1 (Cyfra21-1) and neuron specific enolase (NSE) were tested for every patient. Though receiver operating characteristic (ROC) curves indicated unsatisfactory diagnostic power of those four tumor markers for lung cancer, 37.3% of early-staged lung cancer could be diagnosed just on the combination assays of the four tumor markers, under adjusted cut-off values through our statistical analysis retrospectively.

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.

To explore the impact and reasons of conversion during video-assisted thoracic surgery (VATS) lobectomy.A total of 374 patients undergoing VATS lobectomy during May 2007 and May 2012 were divided into 2 groups according to whether conversion was necessary. And their clinical data were retrospectively analyzed.Among them, 36 cases (9.6%) converted into thoractomy during VATS lobectomy. Their clinical profiles of age, gender and surgical type were similar. The conversion group had longer operative duration, more blood loss and more benign proportion than VATS group.No inter-group difference existed in postoperative complication, mortality; tube removal time or hospitalization length. The reasons of conversion included hemorrhage (n = 12), vascular adhesion (n = 6), instrumentation complication (n = 5), incomplete fissure (n = 5), uncertain anatomy (n = 3), abnormal blood vessels (n = 3) and insufficient margin (n = 2).Conversion during VATS lobectomy may prolong operative duration and increase blood loss.However there is no effect upon patient recovery.

Age-related changes and regional differences in caspase expression were determined in the primate brain. Using immunoblot analysis, the levels of endogenous caspase-3, caspase-9 and cytochrome c-triggered activated caspase-3 were examined in brain homogenates from the prefrontal, motor and visual cortices, cerebellum, hippocampus and amygdala of 4-year-old and 20-year-old rhesus macaques. Procaspase-3 was detected in similar quantities in all brain regions of both young and aging macaques. Being found in all brain regions, caspase-9 was significantly elevated in old macaques as compared to young ones. After incubation with cytochrome c, active forms of caspase-3 were detected in all brain regions of young and old macaques. In almost all brain regions of old monkeys, the levels of cytochrome c-dependent caspase-3 activation were higher than those of young macaques. These results suggest that the aging rhesus macaque brain has a lower threshold to apoptotic stimuli.

Neuroendocrine tumors of the thymus (NETTs) are rare but aggressive, and lead to poor overall survival. This retrospective study was designed to analyze factors that correlate with the prognosis of patients with NETTs.From 1999 to 2015, 41 ongoing patients with NETTs were enrolled in this study. The clinical data and outcome were compiled. Overall survival (OS) rate was analyzed using the Kaplan-Meier method in univariate analysis and the Cox-model was used in multivariate analysis.Of the 41 NETTs patients analyzed (31 male and 10 female), 12 were typical carcinoma, 14 were atypical carcinoma, 14 were small-cell carcinoma and, 1 was large-cell carcinoma. The median follow-up time was 29 months (range, 9.0-69.0). In total, 25 patients died of cancer-related disease by the last follow-up. The 3- and 5-year survival rates for all patients were 42.7% and 23.4%, respectively. Among the prognostic factors analyzed by multivariate analysis, low tumor grade, complete resection, and a negative chromogranin A (CgA) expression were positively correlated with survival.The surgical treatment of NETTs, CgA negative, and low grade of NETTs were associated with a statistically significant better prognosis. However, large, multicenter studies are required to fully validate these prognostic factors.

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 (10 mm) through a minimally invasive approach.The records of 32 patients with 41 small GGOs who underwent intraoperative CT-guided double-thorn hook wire localization prior to video-assisted thoracoscopic wedge resection from October 2009 to October 2013 were retrospectively reviewed. All patients received video-assisted thoracoscopic surgery (VATS) within 10 min after wire localization. The efficacy of intraoperative localization was evaluated in terms of procedure time, VATS success rate, and associated complications of localization.A total of 32 patients (15 males and 17 females) underwent 41 VATS resections, with 2 simultaneous nodule resections performed in 3 patients, 3 lesion resections in 1 patient, and 5 lesions in a patient. Nodule diameters ranged from 2 mm-10 mm (mean: 5 mm). The distance of lung lesions from the nearest pleural surfaces ranged within 5 mm-24 mm (mean: 12.5 mm). All resections of lesions guided by the inserted hook wires were successfully performed by VATS (100% success rate). The mean procedure time for the CT-guided hook wire localization was 8.4 min (range: 4 min-18 min). The mean procedure time for VATS was 32 min (range: 14 min-98 min). The median hospital time was 8 d (range: 5 d-14 d). Results of pathological examination revealed 28 primary lung cancers, 9 atypical adenomatous hyperplasia, and 4 nonspecific chronic inflammations. No major complication related to the intraoperative hook wire localization and VATS was noted.Intraoperative CT-guided hook wire localization is useful, particularly in small GGO localization in VATS wedge resection and has a significantly low rate of minor complications. Lung GGOs carry a 90% risk of malignancy. Aggressive surgical resection of these GGOs is necessary and feasible through the guidance of intraoperative CT localization technique.背景与目的 肺磨玻璃样微小结节（ground glass opacity, GGO）病灶的定位是微创手术切除的技术难点。各种定位方法均有报道，但每一种方法均有其不足。本研究拟通过评价术中CT引导下Hook-wire定位对GGO微创切除的价值，初步探索肺部10 mm的GGO积极手术治疗的必要性和可行性。方法 2009年10月-2013年10月共32例GGO患者，41个GGO，行胸腔镜微创切除术，麻醉插管后皆在手术体位下行计算机断层扫描（computed tomography, CT）CT引导Hook-wire定位。记录术中CT引导下Hook-wire定位技术的失败率、并发症、胸腔镜手术转为开胸手术的几率、住院时间等，计算病灶组织学分型中的恶性几率，讨论肺部10 mm的GGO积极手术治疗的必要性。结果 共32例患者（男性15例，女性17例）行41个GGO胸腔镜微创切除术，其中2个病灶、3个病灶和5个病灶同时微创切除患者数量分别是3例、1例、1例。病灶直径2 mm-10 mm（平均5 mm），病灶距离胸膜垂直距离5 mm-24 mm（平均12.5 mm）。术中CT引导下Hook-wire定位成功率100%，严重并发症发生率0，转化为开胸手术比率为0，CT定位时间平均8.4 min（4 min-18 min），微创切除病灶所需时间平均32 min（14 min-98 min），中位住院时间为8 d（5 d-14 d）。GGOs术后组织学诊断结果为：原位腺癌（肺泡癌）19例，约46.3%，腺癌8例，约19.5%，大细胞癌1例，约2.4%，不典型腺瘤样增生9例，约22%，炎性病灶4例，约9.8%。结论 肺部GGO是恶性病灶的几率很大，对典型GGO患者积极微创手术治疗是非常必要的；术中CT引导下Hook-wire定位技术极大提高GGO微创切除可行性、并发症发生率低，对于GGO的鉴别诊断及治疗具有很好的临床价值。

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.

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.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.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.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.背景与目的 英国学者Anderson和Pierce于1954年首先报道了表现为囊性病变的肺癌。作为少见的肺癌特殊表现类型，薄壁囊性肺癌在临床中经常被误诊。本研究旨在探讨薄壁空洞性肺癌的临床特点、影像学特点，诊断及治疗。方法 自2007年3月-2013年12月，解放军总医院胸外科共收治4,897例原发性肺癌患者，其中24例影像学表现为薄壁空洞型肺癌。我们将影像学上表现为囊性且75%以上囊壁厚度小于4 mm的肺癌定义为薄壁空洞性肺癌。回顾性总结24例病例的临床资料、病理结果及随访情况。结果 薄壁空洞型肺癌在我科同期接受手术的肺癌中比例为0.49%（24/4,897）。其中男性19例，女性5例，平均年龄56.5岁。14例无临床症状，于查体时发现。10例有呼吸道症状。24例患者中18例为腺癌（包括原位腺癌及微浸润腺癌），3例鳞癌，1例大细胞癌，1例小细胞癌，1例腺鳞癌。平均随访时间28个月，3例因肺癌死亡，其余21例未见复发。结论 薄壁空洞型肺癌是肺癌少见的影像学表现类型，临床中应避免误诊。其具体形成机制并不明确，可能是肺癌形成的某一阶段。薄壁空洞型肺癌如能早期诊断，可获得较好预后。

Lung cancer presenting as cysts is a rare entity in clinical practice. Differential diagnosis is difficult in the benign-like cyst.We conducted a retrospective analysis of the clinical records of 15 patients who underwent surgery for primary lung cancer presenting as cysts (wall thickness5 mm) in our department between 2007 and 2012. The whole group underwent postoperative follow-up.The subjects' age ranged from 18 to 80 years with a median age of 58.3 years. Eight cases presented with respiratory symptoms while seven showed abnormal shadows on a chest computed tomography without symptoms. Histological analysis showed that 10 cases were of adenocarcinoma, two of squamous cell carcinoma and one of large cell carcinoma. Two patients died at 13 and 26 months and the remaining 13 patients are alive and disease free at 3-38 months.Cystic lung cancer should be considered in the differential diagnosis of focal benign cyst. Cystic lung cancer could achieve a good outcome if early diagnosis can be obtained.

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.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.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.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.

Positron emission tomography/integrated computed tomography (PET/CT) provides the most accurate imaging modality for preoperative lung cancer staging. However, the diagnostic accuracy of maximum standardized uptake value (SUVmax) for mediastinal (N2) lymph nodes (LN) is unclear. We compared SUVmax, the ratio of LN to primary tumor SUVmax (SUVn/t), and SUVn/t multiplied by maximal tumor diameter (SUVindex) in terms of their abilities to predict mediastinal LN malignancy. We retrospectively analyzed 170 mediastinal LN stations from 73 consecutive patients who underwent systemic LN resection and PET/CT within 27 days. The SUVmax of the primary tumors was >2.0 and the SUVmax of the mediastinal LN stations ranged from 2.0 to 7.0 on PET/CT. Receiver-operating characteristic curves (ROCs) of SUVmax, SUVn/t, and SUVindex were calculated separately and the areas under the curves (AUCs) were used to assess the abilities of the parameters to predict LN malignancy. The optimal cutoff values were calculated from each ROC curve and the diagnostic abilities were also compared. The diagnostic accuracies of the 3 methods were also assessed separately in smoking and nonsmoking patients. Twenty-eight LN stations were malignancy-positive and the remaining 142 were malignancy-negative. The AUCs for SUVindex, SUVn/t, and SUVmax were 0.709, 0.590, and 0.673, respectively, and the optimal cutoff values for SUVindex, SUVn/t, and SUVmax were 1.11, 0.34, and 3.6, respectively. The differences between SUVindex and SUVn/t were significant, but there was no significant difference between SUVindex and SUVmax. There were no significant differences between smokers and nonsmokers in the AUCs for any of the methods for predicting LN malignancy (P values >0.05). SUVindex may be a predictor of mediastinal LN malignancy in lung cancer patients.

Because of their unique design, web-sever clusters have gained much attention and have become increasingly popular for handling requests. When handling large amounts of complex data, load-balancing is a crucial necessity. This paper proposes the implementation of real time monitoring status of tasks and dynamic dispatch strategy in web-sever cluster systems. It devises the multiple priority queues and a redo mechanism for effectiveness and reliability. Implementation of the system is based on Twisted Framework

To explore the causes, clinic diagnosis, treatment and prognosis of inflammatory myofibroblastic tumor (IMT) of the chest.The clinical data of 12 patients with IMT were retrospectively analyzed including 9 male and 3 female patients aged 36 to 81 years (mean 60.08 years). Five patients underwent pulmonary lobectomy and mediastinal lymph node dissection, 1 had partial lobectomy, 1 had mediastinal tumor resection and costectomy, and 2 received conservative treatment.All the surgical patients recovered after surgery without lymph node metastasis detected by pathological examinations. In the follow-up lasting for 2 months to 5 years, no recurrence or metastasis occurred in these cases. In the 2 cases having conservative treatment, the tumor remained unchanged in one case at 3 month of follow-up and disappeared in the other case.IMT in the chest is a rare benign tumor with a low incidence rate and malignancy. Pathological examination is reliable for definite diagnosis. Surgical operation is the primary therapeutic approach. All IMT patients should be closely followed up after the treatment.

To study the clinical characteristics, treatment and prognosis of patients with solitary fibrous tumor of the pleura (SFTP) in order to improve the diagnostic accuracy and treatment of SFTP.A retrospective analysis of clinical and imaging features, serum biochemical changes, pathological characteristics and treatment follow-up results was conducted for 40 SFTP patients from January 1998 to March 2010.A chest CT diagnosis was conducted for 63.6% of the patients; the unenhanced and contrast-enhanced CT findings were significantly different among the cohort (P0.01). Patients lacking a uniform MRI internal signal comprised 88.9% of the group, 66.7% showed T1 isointensity, 33.3% demonstrated T1 hypointensity, 44.4% showed T2 hypointensity and 44.4% had slight hypointensity. The follow-up time was between 2 and 116.9 months, with an average of 35 months; postoperative adjuvant therapy was not administered. Currently, all the studied patients are alive, with no metastasis or recurrence.Chest CT is a valuable tool for diagnosis and surgical decisions, and the efficacy of MRI examination is comparable to chest CT. The majority of cases originated in the visceral pleural; for these, surgical resection is an effective treatment, and the prognosis is generally favorable.

According to the international standard in TNM staging of pulmonary carcinoma, pulmonary carcinoma complicated with diffuse pleural metastasis and malignant pleural effusion belongs to IIIB stage. In the past, non-operative therapy was employed, but both the therapeutic efficacy and the quality of life of patients were poor. The purpose of this study is to find out a complex treatment for this disease.Total pleuro-pneumonectomy was performed in 55 cases of patients with pulmonary carcinoma complicated with diffuse pleural metastasis and malignant pleural effusion from December 1978 to February 2003. The patients were followed up postoperatively, and the quality of life and survival period of them were observed.In all the cases, only 2 patients died of operation. Satisfactory recovery and remarkable relief of symptoms such as short breath, dyspnea and chest pain were found in all the other patients. After a follow-up period of 1-25 years, local recurrence was found in 6 cases (11.3%), and distant metastasis in 42 cases (79.2%). A total of 48 patients died of tumor, with survival period ranging from 5-40 months (average survival period: 15 months; median survival period: 14 months), and 5 patients were still alive in good health.(1) Patients appropriated for operation should be carefully selected in case that postoperative complications influence their smooth recovery; (2) Tumor tissues should be removed as clear as possible; (3) During the operation, close attention should be paid to the protection of incisions; (4) Removal of the tumor tissues can reduce the tumor load, effectively clean the immunosuppressive factors in malignant pleural effusion, and break the immunity block status, which provides basis for the following comprehensive therapy; (5) The quality of life of the patients can be improved and the median survival period can be prolonged by the operation; (6) The long-term survival rate of patients is still unsatisfactory.