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Neoadjuvant camrelizumab(an anti-PD-1 antibody)plus chemotherapy or apatinib(a VEGFR-2 inhibitor)for initially unresectable stage II–III non-small-cell lung cancer:a multicentre,two-arm,phase 2 exploratory study

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Signal Transduction and Targeted Therapy 2024年第7期9卷 3015-3023页

作者： Haoran Xia Han Zhang Zheng Ruan Huibiao Zhang Liangdong Sun Hezhong Chen Yongxin Zhou Lele Zhang Dongliang Bian Xinsheng Zhu Jing Zhang Fenghuan Sun Huansha Yu Nan Song Xiaogang Liu Yuming Zhu Haiping Zhang Wenxin He Jian Chen Jie Yang Guohan Chen Shiliang Xie Dongfang Tang Xiaomiao Zhang Liang Duan Deping Zhao Qinchuan Li Peng Zhang Gening Jiang Department of thoracic surgery Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Department of thoracic surgery Shanghai General HospitalShanghai Jiao Tong University School of MedicineShanghaiChina Department of thoracic surgery Huadong Hospital Affiliated to Fudan UniversityShanghaiChina Department of thoracic surgery Changhai HospitalNaval Medical UniversityShanghaiChina Department of thoracic-Cardiovascular surgery Tongji HospitalTongji University School of MedicineShanghaiChina Central Laboratory Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Experimental Animal Center Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Department of Oncology Shanghai Pulmonary HospitalTongji University School of MedicineShanghaiChina Department of thoracic surgery Shanghai East HospitalTongji University School of MedicineShanghaiChina

This multicentre,two-arm,phase 2 study aimed to explore the efficacy and safety of neoadjuvant camrelizumab plus chemotherapy or apatinib in patients with initially unresectable stage II–III non-small-cell lung cancer(NSCLC).Eligible patients regardless of PD-L1 expression received neoadjuvant camrelizumab 200 mg and platinum-doublet chemotherapy every 3 weeks(arm A)or those with PD-L1-positive tumors received neoadjuvant camrelizumab and apatinib 250 mg once daily(arm B),for 2–4 cycles,followed by *** primary endpoint was major pathological response(MPR)*** patients in arm A and 21 in arm B were *** rates were 50.0%(15/30)in arm A and 42.9%(9/21)in arm B,with all patients achieving R0 *** these patients,the MPR and pathological complete response rates were both 20.0%(95%CI 4.3–48.1)in arm A and were 55.6%(95%CI 21.2–86.3)and 11.1%(95%CI 0.3–48.2)in arm B,*** corresponding objective response rates were 33.3%(95%CI 11.8–61.6)and 55.6%(95%CI 21.2–86.3).With a median follow-up of 22.4 months(95%CI 19.0–26.0),the median event-free survival was not reached(NR;95%CI 13.6-NR)in arm A and 16.8 months(95%CI 8.6-NR)in arm *** 3 or above treatment-related adverse events occurred in eight(26.7%)patients in arm A and three(14.3%)in arm *** analysis showed baseline TYROBP expression was predictive of treatment response in arm *** camrelizumab plus chemotherapy or apatinib exhibits preliminary efficacy and manageable toxicity in patients with initially unresectable stage II–III NSCLC.

关键词： surgery chemotherapy treatment

Diagnosis of chest pain with foregut symptoms in Chinese patients

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World Journal of Gastroenterology 2009年第6期15卷 742-747页

作者： Bo Deng Ru-Wen Wang Yao-Guang Jiang Qun-You Tan Xiang-Li Liao Jing-Hai Zhou Yun-Ping Zhao Tai-Qian Gong Zheng Ma thoracic surgery Department Institute of Surgery Research Daping Hospital The Third Military Medical University Chongqing 400042 China

AIM:To evaluate the diagnosis of chest pain with foregut symptoms in Chinese patients. METHODS:Esophageal manometric studies, 24-h introesophageal pH monitoring and 24-h electrocardiograms(Holter electrocardiography)were performed in 61 patients with chest pain. RESULTS:Thirty-nine patients were diagnosed with non-specific esophageal motility disorders(29 patients with abnormal gastroesophageal reflux and eight patients with myocardial ischemia).Five patients had diffuse spasm of the esophagus plus abnormal gastroesophageal reflux(two patients had concomitant myocardial ischemia),and one patient was diagnosed with nutcracker esophagus. CONCLUSION:The esophageal manometric studies, 24-h intra-esophageal pH monitoring and Holter electrocardiography are significant for the differential diagnosis of chest pain,particularly in patients with foregut *** cases of esophageal motility disorders,pathological gastroesophageal reflux may be a major cause of chest pain with non-specific esophageal motility *** of the esophageal smooth muscle might affect the heart-coronary smooth muscle,leading to myocardial ischemia.

关键词： Chest pain Esophageal manometric Twenty-four-hour intra-esophageal pH monitoring Holter electrocardiography

Value of two-phase dynamic multidetector computed tomography in differential diagnosis of post-inflammatory strictures from esophageal cancer

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World Journal of Gastroenterology 2015年第29期21卷 8878-8887页

作者： Grigory G Karmazanovsky Svetlana A Buryakina Evgeny V Kondratiev Qin Yang Dmitry V Ruchkin Dmitry V Kalinin Department of Radiology Vishnevsky Institute of Surgery Department of thoracic surgery (Esophageal surgery group) Vishnevsky Institute of Surgery Department of Pathomorphology Vishnevsky Institute of Surgery

AIM: To characterize the computed tomography(CT) findings in patients with post-inflammatory esophageal strictures(corrosive and peptic) and reveal the optimal scanning phase protocols for distinguishing postinflammatory esophageal stricture and esophageal ***: Sixty-five patients with esophageal strictures of different etiology were included in this study: 24 patients with 27 histopathologically confirmed corrosive strictures, 10 patients with 12 peptic strictures and 31 patients with esophageal cancer were evaluated with a two-phase dynamic contrast-enhanced MDCT. Arterial and venous phases at 10 and 35 s after the attenuation of 200 HU were obtained at the descending aorta, with a delayed phase at 6-8 min after the start of injection of contrast media. For qualitative analysis, CT scans of benign strictures were reviewed for the presence/absence of the following features: "target sign", luminal mass, homogeneity of contrast medium uptake, concentric wall thickening, conically shapedsuprastenotic dilatation, smooth boundaries of stenosis and smooth mucous membrane at the transition to stenosis, which were compared with a control group of 31 patients who had esophageal cancer. The quantitative analysis included densitometric parameter acquisition using regions-of-interest measurement of the zone of stenosis and normal esophageal wall and the difference between those measurements(ΔCT) at all phases of bolus contrast enhancement. Esophageal wall thickening, length of esophageal wall thickening and size of the regional lymph nodes were also evaluated. RESULTS: The presence of a concentric esophageal wall, conically shaped suprastenotic dilatation, smooth upper and lower boundaries, "target sign" and smooth mucous membrane at the transition to stenosis were suggestive of a benign cause, with sensitivities of 92.31%, 87.17%, 94.87%, 76.92% and 82.05%, respectively, and specificities of 70.96%, 89.66%, 80.65%, 96.77% and 93.55%, respectively. The features that

关键词： Multidetector computed tomography Esophageal cancer Corrosive stricture Peptic stricture

The diagnostic value of tenascin-C in acute aortic syndrome

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Journal of Geriatric Cardiology 2024年第3期21卷 359-368页

作者： Ming MA Wei CHEN Hai-Long CAO Jun PAN Qing ZHOU Xin-Long TANG Dong-Jin WANG Department of thoracic and Cardiovascular surgery Nanjing Drum Tower Hospital Clinical College of Nanjing Medical UniversityNanjingChina Department of thoracic and Cardiovascular surgery Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolNanjing UniversityNanjingChina Department of thoracic surgery Kunshan Hospital of Traditional Chinese MedicineJiangsuChina

OBJECTIVES Misdiagnosis of acute aortic syndrome(AAS)significantly increases ***-C(TN-C)is an extracellular matrix glycoprotein related to cardiovascular *** elevation of TN-C in AAS and whether it can discriminate suddenonset of acute chest pain in Chinese remains *** We measured the plasma concentration of TN-C by ELISA in a cohort of 376 patients with chest or back *** to discriminate AAS from acute coronary syndrome(ACS)were compared and *** From October 2016 to September 2021,376 undiagnosed patients with chest or back pain were enrolled.166 of them were finally diagnosed as AAS,100 were ACS and 110 without cardiovascular diseases(NCV).TN-C was significantly elevated in AAS at 18.18 ng/mL(IQR:13.10–27.68)compared with 7.51 ng/mL(IQR:5.67–11.38)in ACS(P<0.001)and 3.68 ng/mL(IQR:2.50–5.29)in NCV(P<0.001).There was no significant difference in TN-C level among the subtypes of *** the 166 AAS patients,the peaked level of TN-C was at acute stage(P=0.012),then a slight of decrease was observed at subacute *** area under receiver operating characteristic curve for AAS patients versus NCV was 0.979(95%CI:0.964-0.994)for *** a cutoff level of 11.474 ng/mL,TN-C has a sensitivity of 76.0%,specificity of 85.5%,accuracy of 82.0%,positive predictive value(PPV)of 76.0%,negative predictive value(NPV)of 85.5%.Diagnostic performance of TN-C was superior to D-dimer and *** The concentration of serum TN-C in AAS patients was significantly higher than that in ACS patients and ***-C could be a new biomarker to distinguish AAS patients in the early stage after symptoms onset from other pain diseases.

关键词： acute cardiovascular elevated

Minimally invasive versus open esophagectomy for resectable thoracic esophageal cancer(NST 1502):a multicenter prospective cohort study

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Journal of the National Cancer Center 2023年第2期3卷 106-114页

作者： Yousheng Mao Shugeng Gao Yin Li Chun Chen Anlin Hao Qun Wang Lijie Tan Jianqun Ma Gaoming Xiao Xiangning Fu Wentao Fang Zhigang Li Yongtao Han Keneng Chen Renquan Zhang Xiaofei Li Tiehua Rong Jianhua Fu Yongyu Liu Weimin Mao Meiqing Xu Shuoyan Liu Zhentao Yu Zhirong Zhang Yan Fang Donghong Fu Xudong Wei Ligong Yuan Shan Muhammad Jie He Department of thoracic surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina Department of thoracic surgery Henan Cancer HospitalZhengzhouChina Department of thoracic surgery Fujian Medical University HospitalFuzhouChina Department of thoracic surgery Anyang Cancer HospitalAnyangChina Department of thoracic surgery Zhongshang HospitalFudan UniversityShanghaiChina Department of thoracic surgery Heilongjiang Cancer HospitalHarbinChina Department of thoracic surgery Hunan Cancer HospitalChangshaChina Department of thoracic surgery Tongji HospitalTongji UniversityWuhanChina Department of thoracic surgery Shanghai Chest HospitalShanghaiChina Department of thoracic surgery Sichuan Cancer HospitalChengduChina Department of thoracic surgery Beijing Cancer HospitalBeijing UniversityBeijingChina Department of thoracic surgery First Affiliated HospitalAnhui Medical UniversityHefeiChina Department of thoracic surgery The Fourth Military University HospitalXianChina Department of thoracic surgery Sun Yat-sen University Cancer CenterGuangzhouChina Department of thoracic surgery Liaoning Cancer HospitalShenyangChina Department of thoracic surgery Zhejiang Cancer HospitalHangzhouChina Department of thoracic surgery Anhui Provincial HospitalHefeiChina Department of thoracic surgery Fujian Cancer HospitalFujian Medical UniversityFuzhouChina Department of thoracic surgery Tianjin Cancer HospitalTianjinChina

Background:Whether minimally invasive esophagectomy(MIE)is superior to open esophagectomy(OE)in the treatment of esophageal squamous cell carcinoma(ESCC)is still ***,this multicenter prospective study aimed to compare MIE with OE in postoperative parameters and long-term ***:All hospitalized patients with cT1b-3N0-1M0 thoracic ESCC treated by MIE or OE were enrolled from 19 selected centers from April 1,2015 to December 31,*** propensity score matching(PSM)was performed to minimize the selection *** basic clinicopathological characteristics and 3-year overall survival(OS)as well as disease-free survival(DFS)of two groups were compared by R version ***:MIE were performed in 1,387 patients and OE in 335 patients.335 cases in each group were finally matched by PSM,and no significant differences in the essential demographic characteristics were observed be-tween the MIE and OE groups after *** with OE,MIE had significantly less intraoperative bleeding,less total drainage volume,shorter postoperative hospital stay,and harvested significantly more lymph nodes(LNs)(all P<0.001).There were no significant differences in the major postoperative complications and death rates between MIE and *** 3-year OS and DFS were 77.0%and 68.1%in the MIE group versus 69.3%and 60.9%in the OE group(OS:P=0.03;DFS:P=0.09),and the rates were 75.1%and 66.5%in the MIE group versus 66.9%and 58.6%in the OE group for stage cII patients(OS:P=0.04,DFS:P=0.09),***:Compared with OE,MIE is a safe and effective treatment approach with similar mortality and *** has the advantages in harvesting more LNs,improving postoperative recovery and survival of stage cII ESCC patients.

关键词： Minimally invasive esophagectomy Open esophagectomy Lymphadenectomy Postoperative recovery Survival

Safety and feasibility of video-assisted thoracoscopic surgery for stage IIIA lung cancer

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Chinese Journal of Cancer Research 2014年第4期26卷 418-422页

作者： Wenlong Shao Jun Liu Wehua Liang Hanzhang Chen Shuben Li Weiqiang Yin Xin Zhang Jianxing He Department of thoracic surgery The First Affiliated Hospital of Guangzhou Medical University Department of thoracic surgery Guangzhou Institute of Respiratory Diseases Key cite of National Clinical Research Center for Respiratory Diseases

Objective： The current study was prospectively designed to explore the application of video-assisted thoracoscopic surgery （VATS） radical treatment for patients with stage ⅢA lung cancer, with the primary endpoints being the safety and feasibility of this operation and the second endpoints being the survival and complications after the surgery. Methods： A total of 51 patients with radiologically or mediastinoscopically confirmed stage ⅢA lung cancer underwent VATS radical treatment, during which the standard pulmonary lobectomy and mediastinal lymph node dissection were performed after pre-operative assessment. The operative time, intraoperative blood loss/ complications, postoperative recovery, postoperative complications, and lymph node dissection were recorded and analyzed. This study was regarded as successful if the surgical success rate reached 90% or higher. Results： A total of 51 patients with non-small cell lung cancer （NSCLC） were enrolled in this study from March 2009 to February 2010. The median post-operative follow-up duration was 50.5 months. Of these 51 patients, 41 （80.4%） had N2 lymph node metastases. All patients underwent the thoracoscopic surgeries, among whom 50 （98%） received pulmonary lobectomy and mediastinal lymph node dissection completely under the thoracoscope, 6 had their incisions extended to about 6 cm due to larger tumor sizes, and 1 had his surgery performed using a 12 cm small incision for handling the adhesions between lymph nodes and blood vessels. No patient was converted to conventional open thoracotomy. No perioperative death was noted. One patient received a second surgery on the second post-operative day due to large drainage （〉1,000 mL）, and the postoperative recovery was satisfactory. Up to 45 patients （88.2%） did not suffer from any perioperative complication, and 6 （11.8%） experienced one or more complications. Conclusions： VATS radical treatment is a safe and feasible treatment for stage ⅢA lung cancer.

关键词： Lung cancer video-assisted thoracoscopic surgery (VATS) systematic node dissection (SND)

A Cross-Sectional Study: Chest Tube Drainage Practice Patterns among Canadian thoracic Surgeons Following Pulmonary surgery

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Open Journal of thoracic surgery 2017年第1期7卷 14-21页

作者： Samarpita Das Kyle Grant Connie Drewbrook Dorsa Mousadoust Renelle Myers Basil Nasir John Yee Anna McGuire Faculty of Medicine University of British Columbia Vancouver Canada Division of thoracic surgery Vancouver Coastal Health Vancouver Canada

Background: High chest tube drainage following lung surgery is a rate-limiting step to discharge, increasing length of hospital stay. There is a paucity of evidence-based clinical research on safe maximal daily chest tube drainage prior to removal. Objectives: To describe the practice patterns of Canadian thoracic surgeons with respect to daily chest tube drainage after routine pulmonary surgery. Methods: A self-reported electronic questionnaire was administered to members of the Canadian Association of thoracic Surgeons (CATS). Data was tabulated on the primary outcome of acceptable maximal daily pleural output prior to chest tube removal, and secondary outcomes of: years in clinical practice, academic versus community setting and rational for chest tube management. Descriptive and univariate analysis was conducted for each response by maximal daily pleural drainage category. Results: A total of 124 surveys were distributed. Response rate was 56%, with a 93% completion rate. Acceptable maximal pleural drainage among surgeons was highly variable. Rationale for tube removal was also variable, including individual clinical experiences (n = 23, 33%), evidence based guidelines (n = 18, 26%), and group practice pattern (n = 12, 17%). Academic surgeons comprised 72% of respondents. Community based surgeons were more likely to remove tubes at a lower mean volume. Years in clinical practice did not influence acceptable daily pleural drainage. Conclusion: There is great variability in post-operative management of chest tube fluid output among Canadian thoracic surgeons. Future research on this topic is warranted, with the aim of developing an evidence-based chest tube management algorithm incorporating daily chest tube drainage volumes as a key variable.

关键词： thoracic surgery Chest Tubes Oncology Pleural Cavity

Hand-sewn vs linearly stapled esophagogastric anastomosis for esophageal cancer:A meta-analysis

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World Journal of Gastroenterology 2015年第15期21卷 4757-4764页

作者： Xu-Feng Deng Quan-Xing Liu Dong Zhou Jia-Xin Min Ji-Gang Dai Department of thoracic surgery Xinqiao Hospital the Third Military Medical University

AIM: To compare the outcomes of hand-sewn(HS) and linearly stapled(LS) esophagogastric anastomosis for esophageal ***: Before beginning this study, a rigorous protocol was established according to the recommendations of the Cochrane Collaboration. Databases and references were searched for all randomizedcontrolled trials and comparative clinical studies that compared LS with HS esophagogastric anastomosis for esophageal cancer. The primary outcomes compared were anastomotic leak and stricture. Subgroup analyses were performed according to site of ***: Fifteen studies were used, comprising 3203 patients(n = 2027 LS and 1176 HS). Primary outcome analysis revealed a significant decrease in anastomotic leakage(RR = 0.51, 95%CI: 0.41-0.65; P thoracic anastomotic leakage, there was a significant decrease in cervical anastomotic leakage associated with LS(P < 0.00001).CONCLUSION: This meta-analysis indicates that the LS technique contributes to a reduced rate of leakage and stricture compared with the HS method.

关键词： Anastomotic leakage Anastomotic stricture Hand-sewn anastomosis Linearly stapled anastomosis Meta-analysis

Preservation of superior rectal artery in laparoscopically assisted subtotal colectomy with ileorectal anastomosis for slow transit constipation

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World Journal of Gastroenterology 2021年第22期27卷 3121-3129页

作者： Chien-Wei Wu Ta-Wei Pu Jung-Cheng Kang Cheng-Wen Hsiao Chao-Yang Chen Je-Ming Hu Kuan-Hsun Lin Tzu-Chiao Lin Department of surgery Tri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colon and Rectal surgery Department of SurgerySongshan BranchTri-Service General HospitalNational Defense Medical CenterTaipei 10581Taiwan Division of Colon and Rectal surgery Department of SurgeryTaiwan Adventist HospitalTaipei 10556Taiwan Division of Colon and Rectal surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of Colorectal surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan Division of thoracic surgery Department of SurgeryTri-Service General HospitalNational Defense Medical CenterTaipei 11490Taiwan

BACKGROUND Slow transit constipation(STC)has traditionally been considered as a functional ***,evidence is accumulating that suggests that most of the motility alterations in STC might be of a neuropathic *** the patient does not meet the diagnosis of pelvic outlet obstruction and poorly response to conservative treatment,surgical intervention with subtotal colectomy may be *** most unwanted complication of the procedure is anastomotic leakage,however,preservation of the superior rectal artery(SRA)may reduce its *** To evaluate the preservation of the SRA in laparoscopically assisted subtotal colectomy with ileorectal anastomosis in STC *** This was a single-center retrospective observational *** was diagnosed after a series of examinations which included a colonic transit test,anal manometry,a balloon expulsion test,and a barium *** patients underwent laparoscopically assisted total colectomy with ileorectal anastomosis and were examined between January 2016 and January *** operation time,blood loss,time to first flatus,length of hospital days,and incidence of minor or major complications were *** A total of 32 patients(mean age,42.6 years)who had received laparoscopic assisted subtotal colectomy with ileorectal artery anastomosis and preservation of the *** patients were diagnosed with STC after a series of *** mean operative time was 151 min and the mean blood loss was 119 *** mean day of first time to flatus was 3.0 d,and the mean hospital stay was 10.6 *** were no any patients conversions to ***-operative minor complications including 1 wound infection and 1 case of *** was no surgical *** anastomosis leakage was noted in any of the *** Laparoscopically assisted subtotal colectomy with ileorectal anastomosis and preservation of the SRA can significantly improve bowel function with careful patient selection

关键词： Slow transit constipation Superior rectal artery Anastomosis leakage Laparoscopic-assisted colorectal surgery Iliorectal anastomosis Colonic transit time