Xiao Zhou

Background: Perioperative chemoimmunotherapy has suggested a survival benefit in patients with locally-advanced non-small cell lung cancer (NSCLC). This study aims to investigate whether neoadjuvant chemoimmunotherapy influences pulmonary function (PF). Methods: A total of 253 patients with NSCLC who received neoadjuvant chemoimmunotherapy and tumor resection from May 2019 to January 2023 were included. The PF before and after neoadjuvant therapy was compared using a paired t-test, and the difference in the changes of PF between patients with and without chronic obstructive pulmonary disease (COPD) were compared by covariance analysis. Logistic regression analysis was performed to analyze factors influencing the change of PF. Results: The median age was 64 years. The rate of major pathologic response (MPR) was 53.4%, and 11.5% of patients had grade III–IV adverse events. After neoadjuvant chemoimmunotherapy, forced expiratory volume in one second (FEV1) (2.34 vs. 2.45 L, Pvs. 89.50%, Pvs. 0.075 L, P=0.049). Multivariate logistic analysis also found that COPD [odds ratio (OR), 2.273; 95% confidence interval (CI): 1.211–4.405] remained an independent factor for the improvement in FEV1. Conclusions: An improvement in pulmonary ventilation function was observed in NSCLC patients after neoadjuvant chemoimmunotherapy. This improvement may potentially offer additional opportunities for surgical intervention in NSCLC patients with COPD.

Lung cancer (LC) is one of the most prevalent and fatal malignancies worldwide. With the progress of society, the pathogenic factors, medical diagnosis, and environmental health policies of lung cancer have all changed. Therefore, predicting the incidence trend of LC is of significance for people to understand the future burden of LC.In this study, we aimed to analyze temporal trends in LC incidence across 45 areas from 1978 to 2017, investigate regional and demographic patterns of LC incidence, and predict trends from 2018 to 2035. Data on annual LC cases and population statistics, stratified by age and sex, were collected from 111 cancer registries in 45 areas across five continents using the Cancer Incidence in Five Continents Plus database. From 1978 to 2017, age-standardized rates (ASRs) per 100,000 individuals were calculated for both sexes and different age groups. A Bayesian age-period-conhort (BAPC) model was applied to forecast ASRs until 2035. From 1978 to 2017, LC ASRs decreased in most areas for men (32/45 areas) but increased for women (37/45 areas), and mainly due to the rising incidence rate among elderly women (> 60 years old). Among men, the country with the largest increase was Cyprus (+ 71.95%), and the largest decrease was Costa Rica (-64%). Among women, France saw the greatest increase (+ 515.15%) while Kuwait had the least (-72.85%). In addition, the LC ASR in high-income areas is higher than that in middle - and low-income areas. However, projections from 2018 to 2035 suggested that only 8 of 45 areas will witness increasing LC ASRs for men, whereas 18 areas will experience ASR increases for women. Overall, global LC incidence is gradually declining. However, considerable disparities exist across areas, sexes, and developmental stages. Therefore, understanding area-specific trends, customizing control measures to local contexts, and conducting screening and early interventions in high-incidence areas and populations are central to overcoming these differences. Not applicable.

Background: Operating-room specifications do not necessarily predict postoperative infection or surgical-team performance. This study synthesized clinical evidence on environmental control and examined its relevance to an ISO-containerized surgical unit. Methods: PubMed, Web of Science Core Collection, and the Cochrane Library were searched through May 1, 2025. Comparable infection outcomes were pooled using exploratory random-effects meta-analysis. Risk of bias and evidence certainty were assessed, while other outcomes were synthesized narratively. The findings were integrated with nonclinical prototype measurements. Results: Five observational studies (10,774 procedures; 121 infections) contributed to the meta-analysis. Laminar or unidirectional airflow was not significantly associated with surgical-site infection (SSI; three studies; risk ratio [RR] 0.88, 95% confidence interval [CI] 0.46–1.67) or prosthetic joint infection (PJI; two studies; RR 1.33, 95% CI 0.70–2.54). All studies had serious risk of bias, with very low certainty of evidence. Other studies suggested reduced airborne microbial contamination under selected airflow conditions, whereas operative-performance findings were inconsistent. The prototype met selected environmental criteria, but supply-air velocity, humidity, and noise exceeded or fell below specified limits. No intraoperative microbial, operative-performance, or patient outcomes were assessed. Conclusion: Available evidence does not establish that laminar airflow reduces postoperative infection. Partial technical conformity does not establish the prototype’s clinical safety without further validation.

Background: Data regarding the safety and efficacy of delayed completion lobectomy (CL) following sublobar resections remain scant. We evaluated the technical difficulty and short-term outcomes of CL occurring at least 3 months following the anatomical segmentectomy or wedge resection. Methods: Consecutive non-small cell lung cancer (NSCLC) patients who underwent a second resection within the same lobe at least 3 months after their initial resection from January 2013 to December 2019 at the Shanghai Pulmonary Hospital were retrospectively included. The patients were divided into a segmentectomy group (SG group) and a wedge resection group (WR group) based on their initial resection strategy. Baseline characteristics and short-term outcomes after CL between the two groups were compared. Results: Twenty-five patients undergoing CL were included, nine in the SG group and 16 in the WR group. No deaths occurred within 30 days postoperatively, and the rate of overall postoperative complications was 28.0% (7/25). Statistically significant differences were found in rates of postoperative complications between the two groups (SG: 55.6% vs. WR: 12.5%, P=0.03) and in the use of bronchoplasty or angioplasty during the CL (SG: 33.3% vs. WR: 0.0%, P=0.04). After CL, no significant differences were found in 5-year recurrence-free survival (RFS) (WR: 66.7% vs. SG: 61.0%, P=0.31) or overall survival (OS) (WR: 93.8% vs. SG: 66.7%, P=0.06) between two groups. Conclusions: Delayed CL occurring over 3 months after sublobar resection is a safe and effective procedure, with no deaths occurring within 30 days postoperatively. As compared to a segmentectomy at the time of the index operation, a wedge resection may portend less morbidity, with a decreased risk of needing adjunctive bronchoplasty or angioplasty procedures during CL. After CL, 5-year RFS and OS were comparable between WR and SG groups.

DAPK2 activates NF-κB through autophagy-dependent degradation of I-κBα during thyroid cancer development and progression Yan Jiang, Ji Liu, Hua Xu, Xiao Zhou, Liu He, Chenfang Zhu

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality globally. Fine particulate matter (PM2.5) has been indicated to be a major detrimental risk factor for COPD by numerous epidemiological studies. Histone deacetylase 2 (HDAC2), a critical regulator of chromatin remodeling, plays a pivotal role in the development of COPD. However, the underlying mechanisms regarding the relationship between PM2.5 and HDAC2 in the pathogenesis of COPD have yet to be elucidated. In the present study, we aim to investigate the role and the underlying mechanism of HDAC2 in the development of PM2.5-induced COPD. Methods: The effects of PM2.5 exposure on M2 macrophage polarization and the expression levels of HDAC2 were examined in vitro. The influence of HDAC2 deficiency on M2 macrophage polarization and the pathogenesis of COPD was investigated in a PM2.5-induced mouse model. Results: PM2.5 exposure down-regulated the protein level of HDAC2 and enhanced M2 macrophage polarization in vitro. In the COPD murine model, myeloid-specific deficiency of HDAC2 augmented PM2.5-induced M2 polarization of alveolar macrophages (AMs) and up-regulation of tumor necrosis factor (TGF)-β, matrix metallopeptidase (MMP)-9, and MMP-12 in lung tissue, which resulted in more prominent lung function deterioration, airspace enlargement, alveolar wall destruction, and airway remodeling, indicating a key role of HDAC2 in the pathogenesis of PM2.5-induced COPD. Conclusions: PM2.5 facilitated M2 polarization by inhibiting HDAC2, leading to the development of COPD. Targeting of HDAC2 would provide a novel approach to prevent the development of PM2.5 exposure-induced COPD.

Background: Barn-integrated operating rooms have been used in an effort to save space and improve operating room efficiency during orthopedic surgeries. This study aimed to investigate the feasibility of performing several thoracic surgeries in a barn-integrated operating room simultaneously. Methods: Both numerical simulation and field measurement approaches were applied to evaluate the performance of the ventilation system for the barn-integrated operating room. Computational fluid dynamics (CFD) method was applied to simulate airflow velocity field and particle concentration field. On-site test of airflow velocities were measured with a thermal anemometer. Bacteria-carrying particle (BCP) deposition and distribution was estimated using passive air sampling (PAS) and active air sampling (AAS) methods during mock surgeries. Results: The airflow distribution and concentration contours showed the barn-integrated operating room to be highly effective in controlling the concentration of airborne bacteria in the operating fields. The airflow and bacteria count met the current standard of GB50333-2013 Specifications, and there was no evidence of air mixing between cabins. Conclusions: A barn-integrated operating room with several ultraclean operating tables in a single room would be a viable proposition for general thoracic surgeries in the future. As well as achieving a satisfactory level of contamination control, such an approach would reduce operating costs.