Objective To investigate the effectiveness of sequential plate internal fixation in the correction of Madelung deformity after ulnar osteotomy and shortening. Methods The clinical data of 13 patients with Madelung deformity admitted between September 2015 and July 2021 were retrospectively analyzed. There were 5 males and 8 females with an average age of 18.3 years ranging from 17 to 23 years. The disease duration ranged from 12 to 24 months, with an average of 17 months. Three cases had a clear history of trauma. All patients had external radial deviation deformity and limited movement of the ulnar deviation, and the ulnar impact pain was significant during ulnar deviation movement; 9 patients had limited wrist joint supination movement, and the supination movement was normal. In the first stage, ulnar osteotomy and shortening combined with external fixator were used to correct wrist deformity in 13 patients. After operation, bone transfer was performed 6 times per day, with adjustments made every 4 hours, which was 1 mm per day. After the osteotomy was in place, the ulnar plate internal fixation was performed to reconstruct the ulnar stability in the second stage. The Cooney wrist joint score was used to assess the pain, function, range of motion, flexion and extension range of motion, and grip strength of the wrist joint before operation and before the removal of internal fixator. The subjective feeling and appearance satisfaction of patients were recorded. ResultsAfter the second-stage operation, all the 13 patients were followed up 10-22 months, with an average of 15 months. The deformity of wrist joint disappeared after operation, and the flexion, extension, and ulnar deviation were basically normal. There was no complication such as ulnar impingement sign, nonunion or infection. Wrist function, pain, and range of motion were significantly improved after operation, except for 1 patient who had no significant improvement in rotation and pain. The ulnar internal fixator was removed at 10-18 months after the second-stage operation. The scores of pain, function, range of motion, flexion and extension range of motion, and grip strength in the Cooney wrist score before removal of internal fixator significantly improved when compared with those before operation (P<0.05). Subjective and appearance satisfaction of patients were excellent in 9 cases, good in 3 cases, and fair in 1 case. ConclusionUlnar osteotomy and shortening with sequential plate internal fixation for correction of Madelung deformity, with mild postoperative pain, can effectively avoid bone nonunion, improve wrist joint function, and have significant effectiveness.
Objective To investigate the expression and clinical value of long chain non-coding RNA nicotinamide nucleotide hydrogenase antisense RNA1 (LncRNA NNT-AS1), motor neuron and pancreas homeobox protein 1 antisense RNA1 (MNX1-AS1) in lung cancer patients. Methods This study selected 128 patients diagnosed with lung cancer admitted to The Third Medical Center of the General Hospital of the People’s Liberation Army from April 2020 to April 2021 as a cancer group. During the same period, 128 patients with benign pulmonary nodules were regarded as a benign group, and 128 healthy individuals who underwent physical examination were selected as a control group. Quantitative real-time polymerase chain reaction (qRT-PCR) was applied to detect the levels of LncRNA NNT-AS1 and MNX1-AS1 in serum. A three-year follow-up was conducted on all lung cancer patients, with 52 patients in the death group and 76 patients in the survival group. Receiver operator characteristic (ROC) curve was applied to analyze the diagnostic value of serum LncRNA NNT-AS1 and MNX1-AS1 for the occurrence of lung cancer and their predictive value for prognosis. Results Compared with the control group, the serum levels of LncRNA NNT-AS1 and MNX1-AS1 were obviously increased in the benign group and the cancer group (P<0.05). Compared with the benign group, the levels of LncRNA NNT-AS1 and MNX1-AS1 in serum of the cancer patients were obviously increased (P<0.05). The area under ROC curve (AUC) of serum LncRNA NNT-AS1 combined with MNX1-AS1 for the diagnosis of lung cancer was higher than that of LncRNA NNT-AS1 and MNX1-AS1 alone (ZLncRNA NNT-AS1~LncRNA NNT-AS1+MNX1-AS1=2.496, P=0.013; ZMNX1-AS1~LncRNA NNT-AS1+MNX1-AS1=2.831, P=0.007). The levels of LncRNA NNT-AS1 and MNX1-AS1 were related to tumor differentiation, clinical stage, and lymph node metastasis (P<0.05). Compared with the survival group, the serum levels of LncRNA NNT-AS1 and MNX1-AS1 in the death group were obviously increased (P<0.05). The AUC of combined prediction for lung cancer prognosis by serum LncRNA NNT-AS1 and MNX1-AS1 was higher than that predicted by LncRNA NNT-AS1 and MNX1-AS1 alone (ZLncRNA NNT-AS1~LncRNA NNT-AS1+MNX1-AS1=2.539, P=0.011; ZMNX1-AS1~LncRNA NNT-AS1+MNX1-AS1=3.377, P=0.001). Conclusion LncRNA NNT-AS1 and MNX1-AS1 are highly expressed in serum of lung cancer patients, and both have certain value in diagnosis and prognosis evaluation of lung cancer.
Objective To compare the short- and long-term survival of patients with stage T1N0M0 non-small cell lung cancer (NSCLC) undergoing robot-assisted thoracic surgery (RATS) and video-assisted thoracoscopic surgery (VATS). Methods The clinical data of 396 patients with stage T1N0M0 NSCLC treated with RATS or VATS in our hospital from 2012 to 2019 were retrospectively analyzed. There were 209 males and 187 females, with a mean age of 61.58±8.67 years. According to surgical procedures, they were separated into two groups: a RATS group (n=157) and a VATS group (n=239). The two groups were compared in terms of the survival and prognosis-influencing factors. Results The intraoperative blood loss and postoperative 24 h drainage volume in the RATS group were less than those in the VATS group (48±42 mL vs. 182±231 mL, P<0.001; 250±119 mL vs. 324±208 mL, P<0.001). The groups and number of dissected lymph node in the RATS group were more than those of the VATS group (5±2 groups vs. 3±2 groups, P<0.001; 17±9 vs. 11±8, P<0.001). There was no statistical difference in the postoperative 48 h drainage volume (P=0.497), postoperative intubation time (P=0.180) or hospital stay (P=0.313). The survival state and recurrence-free survival state in the VATS group were better than those in the VATS group (1-year survival rate: 98.7% vs. 94.8%, 5-year survival rate: 90.5% vs. 75.8%, 8-year survival rate: 76.9% vs. 62.1%, mean survival time: 93 months vs. 79 months, P=0.005; 1-year recurrence-free survival rate: 97.4% vs. 95.6%, 5-year recurrence-free survival rate: 94.8% vs. 77.8%, 8-year recurrence-free survival rate: 82.6% vs. 64.8%, mean recurrence-free survival time: 95 months vs. 79 months, P=0.004). Univariate analysis showed that surgical method, the groups and the number of dissected lymph nodes were the influencing factors for postoperative overall survival and recurrence-free survival. At the same time, the results of multivariate analysis showed that surgical method was a common independent factor for overall survival and recurrence-free survival.Conclusion RATS can obtain better survival in patients with T1N0M0 NSCLC, and RATS has more thorough lymph node dissection, less intraoperative blood loss and postoperative 24 h drainage volume.
ObjectiveTo evaluate the safety and application value of three-dimensional reconstruction for localization of pulmonary nodules in thoracoscopic lung wedge resection.MethodsThe clinical data of 96 patients undergoing thoracoscopic lung wedge resection in our hospital from January 2019 to August 2020 were retrospectively reviewed and analyzed, including 30 males and 66 females with an average age of 57.62±12.13 years. The patients were divided into two groups, including a three-dimensional reconstruction guided group (n=45) and a CT guided Hook-wire group (n=51). The perioperative data of the two groups were compared.ResultsAll operations were performed successfully. There was no statistically significant difference between the two groups in the failure rate of localization (4.44% vs. 5.88%, P=0.633), operation time [15 (12, 19) min vs. 15 (13, 17) min, P=0.956], blood loss [16 (10, 20) mL vs. 15 (10, 19) mL, P=0.348], chest tube placement time [2 (2, 2) d vs. 2 (2, 2) d, P=0.841], resection margin width [2 (2, 2) cm vs. 2 (2, 2) cm, P=0.272] or TNM stage (P=0.158). The complications of CT guided Hook-wire group included pneumothorax in 2 patients, hemothorax in 2 patients and dislodgement in 4 patients. There was no complication related to puncture localization in the three-dimensional reconstruction guided group.ConclusionBased on three-dimensional reconstruction, the pulmonary nodule is accurately located. The complication rate is low, and it has good clinical application value.
ObjectiveTo investigate the effect and mechanism of microRNA (miR)-146a-3p on acute lung injury (ALI) and inflammation induced by lipopolysaccharide (LPS) in mice.MethodsThirty-two BALB/c mice were randomly divided into sham group, ALI group, ALI+agomiR-negative control (NC) group, ALI+miR-146a-3p agonist (agomiR-146a-3p) group, with 8 mice in each group. The ALI model was established by instilling 5 mg/kg LPS into the lungs through the trachea, and the same amount of saline was instilled slowly in the sham group. The mice in the ALI+agomiR-146a-3p group/NC group were injected with 8 mg/kg agomiR-146a-3p or agomiR-NC respectively through the tail vein, once a day, for 3 days. The sham group and the model group were given the same amount of normal saline injection through the tail vein. After 24 hours, they were sacrificed and lung tissues were collected. The expressions of miR-146a-3p and toll-like receptor 4 (TLR4) mRNA in lung tissue were detected by RT-qPCR, the expression levels of TLR4, cleaved caspase-3, Bcl-2 related X protein (Bax), B cell lymphoma-2 (Bcl-2) protein in lung tissue were detected by Western blot. The changes of lung pathology were observed by hematoxylin-eosin staining. The apoptosis of lung tissue was detected by TdT-mediated dUTP nick-end labeling. The expression levels of IL-1β, IL-6 and TNF-α in lung tissue were detected by enzyme-linked immunosorbent assay (ELISA). The dual luciferase reporting system verified the targeting relationship between miR-146a-3p and TLR4 in MRC-5 cells. MRC-5 cells were divided into control group, LPS group, LPS+miR-146a-3p mimic group, LPS+pcDNA3.1(pc)-TLR4 group, LPS+miR-146a-3p mimic+pc-TLR4 group. 100 nmol/L miR-146a-3p mimic and pc-TLR4 plasmids were transfected into MRC-5 cells separately or jointly for 24 hours, and then treated with 1000 ng/mL LPS or normal saline for 72 hours. The apoptosis rate was detected by flow cytometry. The expression levels of TLR4, cleaved caspase-3, Bax, and Bcl-2 proteins were detected by Western blot. The levels of IL-1β, IL-6 and TNF-α were detected by ELISA.ResultsCompared with the ALI group, the expression of miR-146a-3p was up-regulated, the expressions of TLR4 mRNA and protein were down-regulated, the apoptotic rate was decreased, the expressions of cleaved caspase-3 and Bax protein was down-regulated, the expression of Bcl-2 protein was up-regulated, and the levels of TNF-α, IL-6 and IL-1β in lung tissue were decreased in the lung tissues of the ALI+agomiR-146a-3p group (P<0.05). Dual-luciferase reporter assay confirmed that miR-146a-3p regulates transcription by targeting TLR4 3’UTR sequence (P<0.05). Compared with the LPS group, the expression of TLR4 protein in MRC-5 cells of the LPS+miR-146a-3p mimic group was down-regulated, the apoptosis was reduced, the expressions of cleaved caspase-3 and Bax protein were down-regulated, and the levels of TNF-α, IL-6 and IL-1β in lung tissue were decreased (P<0.05). Overexpression of TLR4 reversed the effect of miR-146a-3p mimic overexpression on LPS-induced apoptosis and inflammation of MRC-5 cells (P<0.05).ConclusionmiR-146a-3p alleviates LPS-induced ALI in mice by down-regulating TLR4.
Objective To observe the effects of exogenous pulmonary surfactant (PS) on ventilation-induced lung injury (VILI) in rats, and to investigate its possible mechanisms. Methods A total of 40 Wistar rats were divided into 4 groups with randomized blocks method: control group, high tidal volume (HV) group, VILI group, and PS group, with 10 rats in each group. The control group was subjected to identical surgical procedure but was never ventilated. After 30 min of mechanical ventilation (MV) with Vt 45 ml/kg, the rats in HV group were killed immediately; rats in the VILI group were continually ventilated for up to 150 min with Vt 16 ml/kg; in the PS group, 100 mg/kg of PS administered intratracheally and with the same settings as VILI group. Mean artery pressure (MAP), blood gas analysis, lung wet to dry weight ratios (W/D), thorax-lung compliance, and cell counts in bronchoalveolar lavage fluid (BALF) were determined. Nuclear factor-κB(NF-κB) activity in lungs was measured by enzyme-linked immunosorbent assay (ELISA), interleukin-8(IL-8) in serum and BALF was determined by radioimmunoassay (RIA). Pathological examination of the lung was performed. Results Injurious ventilation significantly decreased MAP and PaO2/FiO2, but increased NF-κB activity and W/D. MAP and PaO2/FiO2 improved, but NF-κB activity, IL-8 in serum and BALF, and cell counts in BALF reduced significantly in PS group compared with those in VILI group. Histological studies showed reduced pulmonary edema and atelectasis in the PS group. Conclusion PS administered intratracheally can suppress the increased activity of NF-κB induced by VILI, exogenous PS can be used to treat VILI.
Objective To detect the difference of periostin expression in small cell lung cancer (SCLC) cell, and explore its effect on chemoresistance of SCLC patients. Methods The expression of periostin in mRNA and protein was detected by RT-PCR and Western blot analysis in SCLC H69 and multidrug resistant strain H69AR. The expression of periostin was up-regulated by recombinant plasmid-periostin in H69 cell. The survival rate in the transfected group was different from that of the negative control group and uninterrupted group. Results The expression of periostin mRNA and protein in the sensitive strain H69 was lower than that of the multidrug resistant strain H69AR (P<0.05). The recombinant periostin-plasmid was transfected into H69 cells and at the same concentration of chemotherapeutic drugs (cisplatin, etoposide) the survival rate increased significantly (P<0.05). The positive expression rate of periostin in SCLC tissues was 67.44%, and the sensitivity of the chemotherapy group was lower than that of the drug resistant group (P<0.05). Conclusion The expression of periostin in SCLC cell H69 is significantly lower than that of the multidrug resistant strain H69AR and overexpression of periostin increases resistance of the sensitive strain H69 and hence periostin may be involved in SCLC chemoresistance.
ObjectiveTo improve the knowledge of double primary lung cancer. MethodsA case of synchronous double primary lung cancers, who was diagnosed by bronchoscopic examination and immunohistochemical staining in our department in 2012, was analyzed retrospectively. The literatures were review with "double primary, lung cancer, squamous cell carcinoma, small cell lung carcinoma" as the research terms in Wanfang, CNKI and PubMed database. ResultsA 76-year-old male patient complained of intermittent cough, chest pain and wheezing over half a month. Chest computer tomography showed masslike lesion with high density in hilum of right lung. The patient received bronchoscopic examination, the pathological and immunohistochemical findings was squamous cell carcinoma and small cell lung carcinoma. The imaging manifestations and bronchoscopy findings were consistent with pathologic diagnosis. A total of 7 pieces of literature were retrived in above-mentioned databases. Seven patients had long smoke history and 6 were male. Four patients complained about couph and sputum, and 1 patient had chest pain. CT showed masses in the lung or hilus with or without stenosis and obliteration of the bronchus. Five patients were proven by bronchoscopy and biopsy. ConclusionDouble primary lung cancer has characteristics in radiologic features and bronchoscopy performance, so can be early diagnosed by bronchoscopy and histopathology.
Objective To explore the expression and effect of heme oxygenase-1 ( HO-1) in ventilator-induced lung injury. Methods Twenty-four New Zealand rabbits were randomly assigned to three groups, ie. a conventional ventilation + PEEP group( C group) , a ventilator-induced lung injury group( VILI group) , and a VILI + HO-1 inducer hemin group( Hm group) .Western blot and immunohistochemistry assay were used to investigate the expression of HO-1 protein. Blood gas analysis, lung wet /dry ratio, lunghistopathology and lung injury score were used to evaluate lung injury. Results HO-1 protein expression significantly increased in the VILI group compared with the C group. HO-1 was found mainly in alveolar epithelial cells and vascular endothelial cells, as well as in alveolar macrophages and neutrophils. Compared with the VILI group, HO-1 protein and PaO2 /FiO2 increased, while lung wet/dry ratio and lung injury score decreased in the Hmgroup significantly( P lt;0. 05) . Conclusion High HO-1 expression can alleviate lung injury from large tidal volume ventilation, implying its protective role in lung pathogenesis.
ObjectivesTo systematically evaluate the effects of second-generation ALK-inhibitors: Ceritinib and Alectinib on ALK+ NSCLC patients.MethodsPubMed, EMbase, The Cochrane Library, WanFang Data, ClinicalTrials.gov and VIP databases were systematically searched for clinical trials containing treatment of two principal second-generation ALK-inhibitors for ALK (+) NSCLC patients from inception to December 31st, 2017. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias included in the studies. Stata 12.0 software was used for meta-analysis.ResultsEleven studies were included. Meta-analysis showed that the ORR of all was 57% (95%CI 0.48 to 0.66, P<0.001). The ORR of patients with Crizotinib-resistance was 51% (95%CI 0.44 to 0.57,P<0.001). The IDCR of patients who had brain metastases was 78% (95%CI 0.71 to 0.86,P<0.001).ConclusionsThe second-generation ALK-inhibitors has effect on ALK (+) NSCLC. Due to limitation of the included studies, more larger sample studies are required to verify above conclusions.