BACKGROUND Anatomical segmentectomy has been proposed as a substitution for lobectomy for early-stage lung cancer.However,it requires technical meticulousness due to the complex anatomical variations of segmental vess...BACKGROUND Anatomical segmentectomy has been proposed as a substitution for lobectomy for early-stage lung cancer.However,it requires technical meticulousness due to the complex anatomical variations of segmental vessels and bronchi.AIM To assess the safety and feasibility of three-dimensional computed-tomography bronchography and angiography(3D-CTBA)in performing video-assisted thoracoscopic surgery(VATS)for lung cancers.METHODS In this study,we enrolled 123 patients who consented to undergo thoracoscopic segmentectomy and lobectomy assisted by 3D-CTBA between May 2017 and June 2019.The image data of enhanced computed tomography(CT)scans was reconstructed three-dimensionally by the Mimics software.The results of preoperative 3D-CTBA,in combination with intraoperative navigation,guided the surgery.RESULTS A total of 59 women and 64 men were enrolled,of whom 57(46.3%)underwent segmentectomy and 66(53.7%)underwent lobectomy.The majority of tumor appearance on CT was part-solid ground-glass nodule(pGGN;55.3%).The mean duration of chest tube placement was 3.5±1.6 d,and the average length of postoperative hospital stay was 6.8±1.8 d.Surgical complications included one case of pneumonia and four cases of prolonged air leak lasting>5 d.Notably,there was no intraoperative massive hemorrhage,postoperative intensive-care unit stay,or 30-d mortality.Preoperative 3D-CTBA images can display clearly and vividly the targeted structure and the variations of vessels and bronchi.To reduce the risk of locoregional recurrence,the application of 3D-CTBA with a virtual 3D surgical margin help the VATS surgeon determine accurate distances and positional relations among the tumor,bronchial trees,and the intersegmental vessels.Three-dimensional navigation was performed to confirm the segmental structure,precisely cut off the targeted segment,and avoid intersegmental veins injury.CONCLUSION VATS and 3D-CTBA worked in harmony in our study.This combination also provided a new pattern of transition from lesion-directed location of tumors t展开更多
Tutin,an established toxic natural product that causes epilepsy in rodents,is often used as a tool to develop animal model of acute epileptic seizures.However,the molecular target and toxic mechanism of tutin were unc...Tutin,an established toxic natural product that causes epilepsy in rodents,is often used as a tool to develop animal model of acute epileptic seizures.However,the molecular target and toxic mechanism of tutin were unclear.In this study,for the first time,we conducted experiments to clarify the targets in tutin-induced epilepsy using thermal proteome profiling.Our studies showed that calcineurin(CN)was a target of tutin,and that tutin activated CN,leading to seizures.Binding site studies further established that tutin bound within the active site of CN catalytic subunit.CN inhibitor and calcineurin A(CNA)knockdown experiments in vivo proved that tutin induced epilepsy by activating CN,and produced obvious nerve damage.Together,these findings revealed that tutin caused epileptic seizures by activating CN.Moreover,further mechanism studies found that N-methyl-D-aspartate(NMDA)receptors,gammaaminobutyric acid(GABA)receptors and voltage-and Ca2+-activated K+(BK)channels might be involved in related signaling pathways.Our study fully explains the convulsive mechanism of tutin,which provides new ideas for epilepsy treatment and drug development.展开更多
基金National Natural Science Foundation of China,No.81800050Natural Science Fund of Yangzhou City,No.YZ2017119Science and Technology Innovation Cultivation Program of Yangzhou University,No.2017CXJ122.
文摘BACKGROUND Anatomical segmentectomy has been proposed as a substitution for lobectomy for early-stage lung cancer.However,it requires technical meticulousness due to the complex anatomical variations of segmental vessels and bronchi.AIM To assess the safety and feasibility of three-dimensional computed-tomography bronchography and angiography(3D-CTBA)in performing video-assisted thoracoscopic surgery(VATS)for lung cancers.METHODS In this study,we enrolled 123 patients who consented to undergo thoracoscopic segmentectomy and lobectomy assisted by 3D-CTBA between May 2017 and June 2019.The image data of enhanced computed tomography(CT)scans was reconstructed three-dimensionally by the Mimics software.The results of preoperative 3D-CTBA,in combination with intraoperative navigation,guided the surgery.RESULTS A total of 59 women and 64 men were enrolled,of whom 57(46.3%)underwent segmentectomy and 66(53.7%)underwent lobectomy.The majority of tumor appearance on CT was part-solid ground-glass nodule(pGGN;55.3%).The mean duration of chest tube placement was 3.5±1.6 d,and the average length of postoperative hospital stay was 6.8±1.8 d.Surgical complications included one case of pneumonia and four cases of prolonged air leak lasting>5 d.Notably,there was no intraoperative massive hemorrhage,postoperative intensive-care unit stay,or 30-d mortality.Preoperative 3D-CTBA images can display clearly and vividly the targeted structure and the variations of vessels and bronchi.To reduce the risk of locoregional recurrence,the application of 3D-CTBA with a virtual 3D surgical margin help the VATS surgeon determine accurate distances and positional relations among the tumor,bronchial trees,and the intersegmental vessels.Three-dimensional navigation was performed to confirm the segmental structure,precisely cut off the targeted segment,and avoid intersegmental veins injury.CONCLUSION VATS and 3D-CTBA worked in harmony in our study.This combination also provided a new pattern of transition from lesion-directed location of tumors t
基金the Natural Science Foundation of China(No.21732008)CAMS Innovation Fund for Medical Sciences(No.CIFMS-2021-I2M-1-027,CIFMS-2021-I2M-1-028,CIFMS-2022-I2M-JB-009).
文摘Tutin,an established toxic natural product that causes epilepsy in rodents,is often used as a tool to develop animal model of acute epileptic seizures.However,the molecular target and toxic mechanism of tutin were unclear.In this study,for the first time,we conducted experiments to clarify the targets in tutin-induced epilepsy using thermal proteome profiling.Our studies showed that calcineurin(CN)was a target of tutin,and that tutin activated CN,leading to seizures.Binding site studies further established that tutin bound within the active site of CN catalytic subunit.CN inhibitor and calcineurin A(CNA)knockdown experiments in vivo proved that tutin induced epilepsy by activating CN,and produced obvious nerve damage.Together,these findings revealed that tutin caused epileptic seizures by activating CN.Moreover,further mechanism studies found that N-methyl-D-aspartate(NMDA)receptors,gammaaminobutyric acid(GABA)receptors and voltage-and Ca2+-activated K+(BK)channels might be involved in related signaling pathways.Our study fully explains the convulsive mechanism of tutin,which provides new ideas for epilepsy treatment and drug development.
