Objective To investigate the clinical and pathological characteristics, prognosis and treatment strategies of adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA). Methods We retrospectively analyzed the clinical data of 489 patients with AIS and MIA in our hospital from January 2007 to August 2015. There were 122 males and 367 females with an average age of 26–78 (51±9) years. According to the pathological types, they were divided into the AIS group (246 patients) and the MIA group (243 patients). In the AIS group, there were 60 males and 186 females with an average age of 50±7 years. In the MIA group, there were 62 males and 181 females with an average age of 54±5 years. The clinicopathological features, surgical methods and prognosis of the two groups were compared. Results There were significant differences in age, value of carcino-embryonic antigen (CEA), nodule shape and nodule size between the AIS and MIA groups (P<0.05). AIS patients were mostly under the age of 60 years with the value of CEA in the normal range which often appeared as pure ground-glass opacity lung nodules <1 cm in diameter on the CT scan. MIA often appeared as mixed ground-glass nodules <1.5 cm in diameter, accompanied by bronchiectasis and pleural indentation. The 5-year disease-free survival rate of the AIS and MIA groups reached 100%, and there was no statistical difference in the prognosis between the two groups after subtotal lobectomy (pulmonary resection and wedge resection) and lobectomy, systematic lymph node dissection and mediastinal lymph node sampling. Conclusion The analysis of preoperative clinical and imaging features can predict the AIS and MIA and provide individualized surgery and postoperative treatment program.
Objective To assess the efficacy and safety of Lamiophlomis rotata (Benth) Kudo in treating bleeding, pain, and inflammation of different causes. Methods Based on the principles and methods of Cochrane systematic reviews, we searched CBM (from establishment to June 2008), CNKI (1980 to June 2008), MEDLINE (1966 to June 2008), and Cochrane Central Register of Controlled Trials (The Cochrane Library, issue 2, 2008）to identify randomized controlled trials (RCTs) of Lamiophlomis rotata (Benth) Kudo. We assessed the risk of bias of the included RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration’s software RevMan 5.0 was used for meta-analysis. Results We included 70 RCTs, of which there were 20 RCTs on bleeding, 10 RCTs on both bleeding and pain, 29 RCTs on pain, and 11 RCTs on inflammation. Most of the included studies were of low quality with a high risk of bias. ① Bleeding: We included 30 RCTs on bleeding. Meta-analysis showed that Lamiophlomis rotata (Benth) Kudo had a higher total effective rate of hemostasis compared with other hemostatics (OR 3.86, 95%CI 2.56 to 5.82) or the blank control group (OR 14.85, 95%CI 7.16 to 30.80). Patients in the Lamiophlomis rotata (Benth) Kudo group had less blood loss compared with other hemostatics or the blank control group and were associated with shorter duration of bleeding compared with the blank control group, but no statistical difference was noted when compared with other hemostatics. ② Pain: We included 37 RCTs on pain. Meta-analysis showed that Lamiophlomis rotata (Benth) Kudo had a higher total effective rate of analgesia compared with other paregorics (OR 3.01, 95%CI 2.23 to 4.06), the blank control group (OR 6.06, 95%CI 3.14 to 11.70), or placebo (OR 2.91, 95%CI 1.48 to 5.73). Patients in the Lamiophlomis rotata (Benth) Kudo group had lower pain score compared with the blank control group (MD -0.84, 95%CI -0.97 to -0.72). ③ Inflammation: We included 11 RCTs on inflammation. Meta-analysis showed that Lamiophlomis rotata (Benth) Kudo had a higher total effective rate of anti-inflammation compared with other antiinflammatory agents (OR 3.36, 95%CI 1.90 to 5.96). One RCT reported that Lamiophlomis rotata (Benth) Kudo could reduce joint swelling compared with other anti-inflammatory agents. ④ Safety: Twelve RCTs reported mild adverse effects in patients who received Lamiophlomis rotata (Benth) Kudo, such as mild nausea, diarrhea, and stomach discomfort, but no serious adverse effects were observed. Conclusion Current evidence demonstrates that Lamiophlomis rotata (Benth) Kudo is effective and safe in treating bleeding, pain, and inflammation. However, the results should be interpreted with caution because of the heterogeneity among the included studies and the high risk of bias. High quality RCTs with large samples are needed to further prove its effectiveness and safety.
Objective As one of the adult stem cells, adi pose-derived stem cells (ADSCs) have become an important seed cell source for tissue engineering recently. But whether the thawed cryopreserved ADSCs could be used to tissue engineered bone remains unknown. To investigate the effect of cryopreservation on the growth and osteogenesis of ADSCs invitro. Methods The ADSCs were isolated from the adipose aspirates by collagenase digestion method. For the experimental group, the 2nd generation cells were stored with a simple method of cryopreservation by slow cool ing with dimethyl sulphoxide as a cryoprotectant and rapid thawing. After cryopreserved in l iquid nitrogen for 4 weeks, ADSCs were recovered and cultured in osteogenic media, with non-cryopreserved ADSCs as the control group. The osteogenic differentiation was evaluated by alkal ine phosphatase (ALP) staining and Al izarin red O staining at 2 and 3 weeks respectively. The cell growth and osteogenesis of ADSCs were further determined using DNA assay and the ALP activity and calcium content were measured. Results The survival percentage of the cryopreserved cells was 90.44% ± 2.62%. The cell numbers and ALP activity increased with osteogenic induction time, and reach plateaus at 7 days and 11 days, respectively. The ALP staining and Al izarin red O staining results were both positive at 2 weeks and 3 weeks after osteogenic induction, respectively. And no significant difference in the cells number, ALP activity, and calcium content were found between experimental group and control group (P gt; 0.05). Conclusion Cryopreservation does not affect the growth and osteogenesis of ADSCs, and the cryopreserved ADSCs can be used as cell source for tissue engineered bone.
Objective To systematically review the abroad studies on patients for patient safety, and compare them with the current status of domestic studies, so as to provide suggestions for evidence-based strategic decision about how to conduct the education of patients for patient safety and improve the medical quality. Methods The databases of MEDLINE, EMbase and Chinese Biomedical Literature Database (CBM) were searched to identify the relevant studies and their references. Literatures were screened with data extraction in accordance with the predefined inclusive and exclusive criteria. The quality of literatures was assessed with the standard of Cochrane Handbook 5.0 and Critical Appraisal Skills Programme, and the data were comprehensively analyzed with qualitative research methods.Results Among 28 included studies, 5 were Chinese literatures, 1 was RCT, and the others were cross-sectional studies. The results showed that: a) Generally, the patients at home and abroad were poor in the awareness of patient safety, but they were eager to participate in the patient safety; b) Factors affecting patients’ participation were their characteristics, disease-related, and emotional feelings; c) Three studies reported the methods of involving patients in patient safety from the aspects of infection, malpractice, and medication; d) Some studies showed that patients’ participation could effectively promote the standardized operation of medical staffs, prevent unsafe events, and reduce damages; and e) The research contents of the included Chinese literatures were just related to the patients’ awareness of patient safety, attitude to participation, and influencing factors. Conclusion The limited studies relevant to patients for patient safety are short of high-quality RCTs for proving the effectiveness of patient participation methods, so it indicates that the stress should be laid on evaluating the effectiveness of patients for patient safety in future research.
Objective To develop a computer-aided diagnosis model for lung cancer based on routine health examination data for identifying individuals with a current high risk of lung cancer in health screening settings, thereby providing decision support for subsequent clinical confirmation. Methods Individuals who underwent health examinations at the Health Management Center of West China Hospital, Sichuan University, between 2010 and 2022 were enrolled. After screening, a retrospective cohort of 5257 subjects was retained, comprising 1307 patients with lung cancer and 3950 non-lung cancer controls. A three-tier feature fusion model was designed: Heterogeneous feature encoding module: a multi-layer perceptron and bidirectional encoder representations from transformers (BERT) were employed to extract feature vectors from structured data and unstructured data (medical records and imaging report texts), respectively. Heterogeneous feature fusion architecture: dimensional expansion concatenation coupled with a gated recurrent unit based gating network was implemented to achieve multi-scale feature alignment and deep interaction, thereby addressing dimensional discrepancies and information redundancy. Attention-based decision mechanism: word-level attention with weighted pooling was applied to dynamically capture key features and generate risk probability distributions. Model performance was evaluated using precision, recall, F1-score, and the area under the receiver operating characteristic curve (AUC-ROC). Results The proposed model significantly outperformed both single-data-type models and simple concatenation approaches. On the test set, the proposed model achieved a recall of 0.861, an F1-score of 0.882, and an AUC-ROC of 0.972, substantially surpassing the best-performing model trained on structured data alone (extreme gradient boosting: recall=0.630, F1-score=0.725, AUC-ROC=0.916) and the model trained on unstructured data alone (BERT coupled with a bidirectional long short-term memory network: recall=0.833, F1-score=0.846, AUC-ROC=0.944). Feature elimination experiments demonstrated minimal performance variation across different feature subsets, confirming the model’s capability to effectively identify and mitigate the impact of irrelevant features. Subgroup analyses revealed that the model performed optimally in female subjects (recall=0.835, F1-score=0.838, AUC-ROC=0.950) and individuals aged >69 years (recall=0.913, F1-score=0.875, AUC-ROC=0.911). Conclusion The proposed model based on heterogeneous health examination data can identify high-risk individuals for lung cancer among health examination populations using only routine screening data, thereby facilitating the early diagnosis of lung cancer in this population.