Abstract Background: Non-smokers account for a large proportion of lung cancer patients, especially in Asia, but the attention paid to them is limited compared with smokers. In non-smokers, males display a risk for lung cancer incidence distinct from the females—even after excluding the influence of smoking; but the knowledge regarding the factors causing the difference is sparse. Based on a large multicenter prospective cancer screening cohort in China, we aimed to elucidate the interpretable sex differences caused by known factors and provide clues for primary and secondary prevention. Methods: Risk factors including demographic characteristics, lifestyle factors, family history of cancer, and baseline comorbidity were obtained from 796,283 Chinese non-smoking participants by the baseline risk assessment completed in 2013 to 2018. Cox regression analysis was performed to assess the sex difference in the risk of lung cancer, and the hazard ratios (HRs) that were adjusted for different known factors were calculated and compared to determine the proportion of excess risk and to explain the existing risk factors. Results: With a median follow-up of 4.80 years, 3351 subjects who were diagnosed with lung cancer were selected in the analysis. The lung cancer risk of males was significantly higher than that of females; the HRs in all male non-smokers were 1.29 (95% confidence interval [CI]: 1.20–1.38) after adjusting for the age and 1.38 (95% CI: 1.28–1.50) after adjusting for all factors, which suggested that known factors could not explain the sex difference in the risk of lung cancer in non-smokers. Known factors were 7% (|1.29–1.38|/1.29) more harmful in women than in men. For adenocarcinoma, women showed excess risk higher than men, contrary to squamous cell carcinoma; after adjusting for all factors, 47% ([1.30–1.16]/[1.30–1]) and 4% ([7.02–6.75]/[7.02–1])) of the excess risk was explainable in adenocarcinoma and squamous cell carcinoma. The main causes of gender differences in lung cancer risk were lifestyle factors, baseline comorbidity, and family history. Conclusions: Significant gender differences in the risk of lung cancer were discovered in China non-smokers. Existing risk factors did not explain the excess lung cancer risk of all non-smoking men, and the internal causes for the excess risk still need to be explored; most known risk factors were more harmful to non-smoking women; further exploring the causes of the sex difference would help to improve the prevention and screening programs and protect the non-smoking males from lung cancers.
Familial risk of lung cancer has been widely studied but whether this association holds in non-smoking females is largely unknown. We sought to determine the relationship between a family history of cancer and lung cancer risk among Chinese non-smoking females based on a multi-center prospective population-based cohort study involving 547,218 individuals between 2013 and 2019. A total of 1620 lung cancer cases occurred during a median follow-up of 3.9 years. Multivariable Cox regression showed that a family history of lung cancer in first-degree relatives significantly increased the risk of lung cancer (HR: 1.50, 95%CI: 1.29, 1.75,
Stage IA lung adenocarcinoma manifested as part-solid nodules (PSNs), has attracted immense attention owing to its unique characteristics and the definition of its invasiveness remains unclear. We sought to develop a nomogram for predicting the status of lymph nodes of this kind of nodules.A total of 2,504 patients between September 2018 to October 2020 with part-solid nodules in our center were reviewed. Their histopathological features were extracted from paraffin sections, whereas frozen sections were reviewed to confirm the consistency of frozen sections and paraffin sections. Univariate and multivariate logistic regression analyses and Akaike information criterion (AIC) variable selection were performed to assess the risk factors of lymph node metastasis and construct the nomogram. The nomogram was subjected to bootstrap internal validation and external validation. The concordance index (C-index) was applied to evaluate the predictive accuracy and discriminative ability.We enrolled 215 and 161 eligible patients in the training cohort and validation cohort, respectively. The sensitivity between frozen and paraffin sections on the presence of micropapillary/solid subtype was 78.4%. Multivariable analysis demonstrated that MVI, the presence of micropapillary/solid subtype, and CTR >0.61 were independently associated with lymph node metastasis (p < 0.01). Five risk factors were integrated into the nomogram. The nomogram demonstrated good accuracy in estimating the risk of lymph node metastasis, with a C-index of 0.945 (95% CI: 0.916-0.974) in the training cohort and a C-index of 0.975 (95% CI: 0.954-0.995) in the validation cohort. The model's calibration was excellent in both cohorts.The nomogram established showed excellent discrimination and calibration and could predict the status of lymph nodes for patients with ≤3 cm PSNs. Also, this prediction model has the prediction potential before the end of surgery.
Background: Most retinal detachments associated with retinopathy of prematurity (ROP) are radial, segmental, or circumferential with cicatricial extraretinal fibrovascular proliferation (EFP) at the apex of the detachment. This report describes peculiar tent-shaped retinal detachments that developed among eyes with ROP. Methods: An observational case series consisting of 9 patients and 13 eyes with tent-shaped retinal detachments. Their morphology, clinical baseline, surgical course, and final retinal status were extracted from medical records. Results: Eight had simple tent-shaped retinal detachments, three had a double tent-shaped retinal detachment, one had a chevron-based retinal detachment, and one had a star-shaped retinal detachment. Each case had a disk based stalk that extended to the apex of the traction retinal detachment and continued anteriorly; 12 stalks inserted in the retrolental space and 1 terminated in the mid vitreous. Six eyes were stage 4A, two eyes were stage 4B, and five eyes were stage 5. Vitrectomy surgery was performed on 11 eyes. Surgery resulted in retinal attachment in nine eyes, and two retinas remained detached. Conclusion: Tent-shaped retinal detachments are seen in patients with ROP. A stalk should be sought in evaluation of these eyes. Vitreous surgery focused on relieving this traction is often successful.
Purpose We aimed to investigate the efficacy and safety of thoracoscopic radical resection of lung cancer in the treatment of patients with stage IIIA non-small cell lung cancer (NSCLC) after neoadjuvant chemotherapy. Methods A total of 132 NSCLC patients (stage IIIA) were collected. Among them, 66 received preoperative neoadjuvant chemotherapy and thoracoscopic radical resection of lung cancer (NACT group), and 66 underwent thoracoscopic radical resection of lung cancer directly (control group). Next, the downstaging of the tumor was analyzed after neoadjuvant chemotherapy, and the R0 resection rate, surgical conditions, postoperative complications, and changes in the levels of serum tumor markers were compared between the two groups of patients. Results The response rate of neoadjuvant chemotherapy was 51.5% (34/66), and the overall downstaging rate was 53.0% (35/66) after neoadjuvant chemotherapy, with 34 cases of T downstaging and 35 cases of N downstaging. The operative time was clearly shorter in the NACT group than that in control group. The R0 resection rate in the NACT group was prominently higher than that in the the control group. The follow-up results uncovered that the 3-year overall survival (OS) and 3-year progression-free survival (PFS) rates were 50.0% and 21.2％ in the NACT group, and 36.4% and 6.1% in the control group, respectively. Based on the results of log-rank test, the OS and PFS of patients in the NACT group were markedly better than those in the control group. Conclusions Neoadjuvant chemotherapy benefits patients with NSCLC (stage IIIA), and it is capable of effectively leading to pathological down-staging, elevating the R0 resection rate, significantly improving the survival of patients and considerably repressing the progression of the disease.
Objective To explore the ultrasonic diagnoses of hip joints with Graf method.Methods Static ultrasonic examinations of bilateral hip joints with the frequency being 7.5～4MHz were made in 74 infants.Results 148 images of hip joints were got,including 130 Type I cases(87.8%) which consisted of 86 Type Ia cases and 44 Type Ib cases.There were 18 Type II cases(12.2%) which included 1 Type IIa cases and 17 Type IIb cases.No Type III or Type IV2 cases were detected.Conclusion Ultrasonic diagnoses of the developmental dysplasia of hip joints can function better than routine mehods and X-ray examination.
Neoadjuvant immunotherapy has brought new hope for patients with non-small cell lung cancer (NSCLC). However, limited by the lack of clinically feasible markers, it is still difficult to select NSCLC patients who respond well and to predict patients' clinical outcomes before the treatment. Before the treatment, we isolated plasma extracellular vesicles (EVs) from three cohorts (discovery, training and validation) of 78 NSCLC patients treated with neoadjuvant immunotherapy. To identify differentially-expressed EV long RNAs (exLRs), we employed RNA-seq in the discovery cohort. And we subsequently used qRT-PCR to establish and validate the predictive signature in the other two cohorts. We have identified 8 candidate exLRs from 27 top-ranked exLRs differentially expressed between responders and non-responders, and tested their expression with qRT-PCR in the training cohort. We finally identified H3C2 (P = 0.029), MALAT1 (P = 0.043) and RPS3 (P = 0.0086) significantly expressed in responders for establishing the predictive signature. Integrated with PD-L1 expression, our signature performed well in predicting immunotherapeutic responses in the training (AUC=0.892) and validation cohorts (AUC=0.747). Furthermore, our signature was proven to be a predictor for favorable prognosis of patients treated with neoadjuvant immunotherapy, which demonstrates the feasibility of our signature in clinical practices (P = 0.048). Our results demonstrate that the exLR-based signature could accurately predict responses to neoadjuvant immunotherapy and prognosis in NSCLC patients.
Objective
To observe the clinical efficacy of surgical operation combined with photodynamic therapy for plantar warts.
Methods
From July 2017 to June 2018, 16 patients with plantar warts were enrolled in the Department of Dermatology, the Fifth People's Hospital of Suzhou City. The enrolled patients aged 10 to 42 years, including 12 males and 4 females, with a course of 4 to 15 month, and a total of 47 plantar warts. The plantar warts was removed by surgical operation and bipolar coagulation, followed by the photodynamic treatment with 5-aminolevulinic acid for 3 to 4 times with an interval of 7-10 days.
Results
Eleven patients showed complete clearance after operation and three times photodynamic treatments, and the other 5 patients underwent 2 operations and four times photodynamic treatments. 47 plantar warts in 16 patients were disappeared completely during 6-month post-treatment follow up. The plantar warts clearance rate was 100%, and the skin texture still presented. In addition to local mild erythematous, pain and burning sensation presented after surgery, but no adverse reactions such as infection, ulcers and obvious scars occurred.
Conclusions
Surgery combined with 5-aminolevulinic acid photodynamic therapy is a favorable treatment for plantar warts.
Key words:
Metatarsus; Warts; Surgical procedures; Photodynamic therapy; Aminolevulinic acid
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