The purpose of this study was to compare the predictive ability of five obesity indices, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHpR) and body adiposity index (BAI), to predict multiple non-adipose metabolic risk factors, including elevated blood pressure (BP), elevated fasting plasma glucose (FPG), elevated triglyceride (TG), reduced high-density lipoprotein cholesterol (HDL-C), elevated serum uric acid (SUA) and non-alcoholic fatty liver disease (NAFLD), in an elderly Chinese population. A total of 5685 elderly Chinese subjects (≥60 years) were recruited into our community-based cross-sectional study. Receiver operating characteristic curve (ROC) analyses were used to compare the predictive ability as well as determine the optimal cut-off values of the obesity indices for multiple metabolic risk factors. According to the areas under the receiver operating characteristic curve (AUC), BMI, WC and WHtR were able to similarly predict high metabolic risk in males (0.698 vs. 0.691 vs. 0.688), while in females, BMI and WC were able to similarly predict high metabolic risk (0.676 vs. 0.669). The optimal cut-off values of BMI, WC and WHtR in males were, respectively, 24.12 kg/m2, 83.5 cm and 0.51, while in females, the values were 23.53 kg/m2 and 77.5 cm.

BackgroundThe present study evaluated the predictive ability of five known “best” obesity and lipid-related parameters, including body mass index (BMI), waist-to-height ratio (WHtR), triglyceride-to-high-density-lipoprotein-cholesterol (TG/HDL-C), lipid accumulation product (LAP) and visceral adiposity index (VAI), in identifying metabolic syndrome (MetS) in Chinese elderly population.MethodsA total of 6722 elderly Chinese subjects (≥60 years) were recruited into our community-based cross-sectional study from April 2015 to July 2017. The anthropometrics, blood pressure, fasting plasma glucose, blood lipid profiles, family history and health-related behaviours were assessed.ResultsThe prevalence of MetS was 40.4% (32.5% in males and 47.2% in females). With the increase in the number of MetS components (from 0 to 5), all the five parameters showed an increase trend in both genders (all P for trend < 0.001). According to receiver operating characteristic curve (ROC) analyses, all the five parameters performed high predictive value in identifying MetS. The statistical significance of the areas under the curves (AUCs) differences suggested that the AUCs of LAP were the greatest among others in both genders (AUCs were 0.897 in males and 0.875 in females). The optimal cut-off values of LAP were 26.35 in males and 31.04 in females. After adjustment for potentially confounding factors, LAP was strongly associated with the odds of having MetS in both genders, and ORs for MetS increased across quartiles using multivariate logistic regression analysis (P < 0.001).ConclusionLAP appeared to be a superior parameter for predicting MetS in both Chinese elderly males and females, better than VAI, TG/HDL-C, WHtR and BMI.

Background: Considering the complexity of vascular or bronchial variations and the difficulty of nodule localization during segmental resection, the three-dimensional (3D) reconstruction and printing model can provide a guarantee for safe operation and, to some extent, can simplify the surgical procedure. We conducted this study to estimate the avail of 3D reconstruction and personalized model in anatomical partiallobectomy (APL).Methods: We prospectively collected and retrospectively reviewed the data of 298 cases who underwent APL in our institute from April 2017 to May 2019. The patients were divided into "3D-reconstruction" group (131 patients), "3D model" group (31 patients) and "non-3D" group (136 patients). We adopted the ANOVA analysis and Chi-square test to compare the perioperative data between the three groups. Subjective satisfaction questionnaires for surgeons were provided to evaluate the value of personalized 3D printed model. Results:The proportion of complex segmentectomy in 3D model group (87.1%) was significantly higher than that in the 3D-reconstruction group (60.3%) and non-3D group (55.9%) (P=0.006), and the average operation time of complex segmentectomy in 3D model group (99.56 minutes) was significantly shorter than that of the other group (all P<0.05). The average intraoperative blood loss in the 3D model group (12.9 mL) was significantly lower than that in the 3D reconstruction group (20.9 mL) (P=0.001) and non-3D group (18.2 mL) (P=0.022). For simple segmentectomy, the operation time, postoperative drainage, and postoperative hospital stay were similar among the three groups. The questionnaire survey showed that most surgeons were satisfied with the clinical effectiveness of the personalized 3D printed model.Conclusions: 3D printing technology can improve understanding of the anatomy, decrease the operation time, and reduce the potential risk of thoracoscopic anatomical partial lobectomy in stage I lung cancer. A pre-operative rating scale was designed to standardize the application of this technology.

Background: Synovial sarcoma (SS) is a rare malignant soft tissue tumor. Primary intrathoracic SS is extremely rare, with limited diagnosis and treatment experiences. The aim of our study was to retrospectively study the clinicopathological characteristics, treatment and prognosis of primary intrathoracic SS and the impact of multidisciplinary team (MDT) management in diagnosis and treatment on patient prognosis. Methods: The clinical and pathological characteristics, treatment, survival and prognosis of patients with primary intrathoracic SS admitted to the National Cancer Center from January 1999 to December 2018, as well as MDT intervention during diagnosis and treatment, were retrospectively analyzed. Results: Thirteen patients were enrolled, including 7 (53.8%) males and 6 (46.3%) females, with primary intrathoracic SS in the lung (8/13, 61.5%), mediastinum (4/13, 30.8%) and pleura (1/13, 7.7%) as confirmed by morphological observation, immunohistochemical (IHC) staining and fluorescence in situ hybridization (FISH). Overall, 10/13 (76.9%) patients underwent surgery, and 6/10 (60.0%) received postoperative adjuvant therapy. Only 23.1% of patients received nonsurgical therapy. The MDT discussed and managed seven patients before and/or after surgery and one patient who did not undergo surgery. The estimated 3and 5-year overall survival (OS) rates were 50.0% and 30.0%, respectively. Patients who were managed by an MDT had a longer median OS time than those who were not (46.0 vs. 18.0 months). Age (P=0.018), tumor location (P=0.029), and Ki-67 (P=0.020) were found to be significantly related to OS.Conclusions: Monophasic morphology and fusion gene characteristics are the main features for the diagnosis of primary intrathoracic SS. MDT management can help obtain accurate diagnoses and provide reasonable therapeutic options.

Background: Pulmonary neuroendocrine tumors (PNETs) are a special subtype of lung cancer with treatment methods are limited and prognostic indicators are insufficient. The preoperative systemic immuneinflammation index (SII) and prognostic nutritional index (PNI) are effective tumor biomarkers that have important significance for the prognosis of many malignant tumors. However, there is no similar research on the predictive value of SII and PNI for operable PNETs. Our study aimed to clarify the predictive value of SII and PNI in PNETs patients after surgical resection.Methods: This study retrospectively analysed the relevant clinical data of PNETs patients who received surgical treatment from 2005 to 2015, which was obtained from patient's clinical records, blood test results recorded on admission before surgical treatment, and follow-up by hospital records.Results: A total of 381 PNETs patients were enrolled in this study. Preoperative PNI was associated with age (P=0.001), T stage (P=0.001), tumor length (P=0.002), drinking status (P=0.013) and smoking status (P=0.049), while SII was significantly associated with T stage (P=0.001), tumor length (P=0.001) and TNM stage (P=0.001). There was significant difference between high SII and low PNI and worse OS of PENTs (P=0.001 and P<0.001). SII (P=0.002), neutrophil/lymphocyte ratio (NLR) (P<0.001), platelet/lymphocyte ratio (PLR) (P=0.001), lymph node metastasis (P<0.001), operation time (P=0.034<0.05), treatment (P<0.001) and PNI (P=0.044<0.05) were independent prognostic factors for PNETs identified by multivariate Cox regression analysis.Conclusions: High SII and low PNI indicated poor prognosis of patients with PNETs. Both of SII and PNI can predict the prognosis of PNETs and stratify patients for better treatment.