Abstract. The aim of the present study was to investigate the anticancer effect of quercetin (QC) in the human lung cancer cell line A-549 and further study the mechanism of apoptosis induction by QC. Low differentiation potential A-549 human lung cancer cells were treated with QC at different doses and for different times, and the growth inhibitory rates were detected by MTT assay. Apoptosis induced by QC in A-549 cells was observed by Annexin V/PI double staining and flow cytometric assay. The relative tumor growth ratio of the treated/control tumors (T/C) (%) was chosen to represent the tumor growth inhibition of A-549 cell nude mouse xenografts by QC. Apoptosis of the nude mouse xenografts was observed by Annexin V/PI double staining and flow cytometric assay and DNA fragmentation assay. To further determine the molecular mechanism of apoptosis induced by QC, changes in the expression of bcl-2 and bax genes were detected by RT-PCR. Following incubation with QC, the cell growth of the low differentiation potential A-549 human lung cancer cells was dramatically inhibited in a dose-dependent manner. After the cells were exposed to QC for 24, 48 and 72 h, the IC 50 value was 1.02±0.05, 1.41±0.20 and 1.14±0.19 µmol/l, respectively. Apoptosis in the A-549 cells induced by QC was noted. The apoptotic subpopulation of A-549 cells was approximately 12.96 and 24.58%, respectively, when cells were incubated with 1.2 µmol/l QC for 48 and 72 h. T/C (%) of A-549 nude mouse xenografts was 44.3, when the nude mice were treated with QC (8 mg/kg). Meanwhile, apoptosis induced by QC was observed in the A-549 nude mouse xenografts. Increased expression of the bax gene and decreased expression of the bc1-2 gene were noted using RT-PCR. Our results provide further evidence of the growth inhibition of the A-549 human lung adenocarcinoma cancer cell line by QC. This effect is associated with the induction of apoptosis in A-549 cells and the molecular mechanism may be related to the reduction in expression of the apoptosis-regulating gene bcl-2, and increase in expression of the apoptosis-regulating gene bax. These results were also confirmed in vivo.

Rationale : Glioma is the most common malignant primary brain tumor in the central nervous system (CNS). The lack of reliable noninvasive diagnostic and prognostic methods is one of the main reasons for the high mortality of glioma. Serum has become a useful biomarker for the diagnosis and prognosis prediction of glioma because extracellular vesicles (EVs) carry molecular components from their parental cells. Methods : To detect EVs and perform molecular analysis of serum EVs, we established and optimized a microbead-assisted method based on flow cytometry and estimated the efficacy of EGFR protein expression and NLGN3 and PTTG1 mRNA in serum EVs from glioma patients (n=23) and healthy individuals (n=12). We evaluated the ability of EGFR + EVs to differentiate high-grade and low-grade glioma patients and checked the correlation between EGFR in EVs and the ki-67 labeling index (LI) in the tumor tissue. Results : We demonstrated that EGFR + EVs are effective diagnostic and prognostic markers of glioma. The expression of EGFR in serum EVs can accurately differentiate high-grade and low-grade glioma patients, and EGFR in EVs positively correlates with ki-67 LI in the tumor tissue. We also showed the potential of NLGN3 and PTTG1 mRNA in EVs for detecting glioma patients. Conclusions : We demonstrate that the protein expression of EGFR in serum EVs is an effective diagnostic marker of glioma. EGFR in EVs highly correlates with the malignancy of glioma. We also show the potential of NLGN3 and PTTG1 in EVs for detecting glioma. The optimized flow cytometry with the aid of microbead-based EV enrichment show its potential as a noninvasive method for the detection of glioma and will be beneficial to the management of glioma.

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.

ObjectiveTo discuss the dual energy spectral computer tomography (CT) imaging features of the pathological grading of clear cell renal cell carcinoma (ccRCC) and the correlation between spectral CT imaging features and pathology.Materials and methodsWe performed analyses of 62 patients with confirmed diagnosis of ccRCC. All patients underwent non-enhanced CT and dual-phase (cortex phase, CP and parenchyma phase, PP) contrast-enhanced CT with dual energy spectral mode. The subjects were pathologically divided into two groups: low-grade group (Fuhrman 1/2) and high-grade group (Fuhrman 3/4). The CT value of each lesion was measured on the monochromatic image at 70 keV. The normalized iodine concentrations (NIC) and the slope of the spectrum curve were calculated. The qualitative morphological parameters, including tumor shape, calcification, pseudocapsule, necrosis, and enhancement mode, were compared between the two groups. The quantitative data were compared using Student’s t-test, and the enumeration data were analyzed using the chi-square test between low-grade and high-grade ccRCC.Receiver operating characteristic curve was used to determine the sensitivity and specificity of the quantitative parameters in two groups.ResultsThe CT value, NIC, and mean slope of the low-grade group were increased compared with the high-grade group during CP (P = 0.001, P = 0.043, and P<0.001, respectively). The CT did not differ significantly during PP (P = 0.134); however, the NIC and mean slope varied considerably in the low grade compared with the high-grade group (P = 0.048, P = 0.017, respectively). The CT threshold value, NIC, and slope had high sensitivity and specificity in differentiating low-grade ccRCC from high-grade ccRCC. The tumor shape, pseudocapsule, and necrosis differed significantly between the two groups (P<0.05).ConclusionsDual energy spectral CT with the quantitative analysis of iodine concentration and qualitative analysis of morphological characteristics increases the accuracy of diagnosing the pathological grade of ccRCC.

BackgroundCompared to the pulmonary lobe, the anatomical structure of the pulmonary segment is relatively complex and prone to variation, thus the risk and difficulty of segmentectomy is increased. We compared three‐dimensional computed tomography bronchography and angiography (3D‐CTBA) combined with 3D video‐assisted thoracic surgery (3D‐VATS) to perform segmentectomy to conventional two‐dimensional (2D)‐VATS for the treatment of non‐small cell lung cancer (NSCLC).MethodsWe retrospectively reviewed the data of randomly selected patients who underwent 3D‐CTBA combined with 3D‐VATS (3D‐CTBA‐VATS) or 2D‐VATS at the Department of Thoracic Surgery, The First Affiliated Hospital of Soochow University Hospital, from January 2014 to May 2017.ResultsThe operative duration of 3D group was significantly shorter than the 2D group (P < 0.05). There was no significant difference in the number of dissected lymph nodes between the two groups (P > 0.05). The extent of intraoperative bleeding and postoperative drainage in the 3D group was significantly lower than in the 2D group (P < 0.05). Chest tube duration in the 3D group was shorter than in the 2D group (P < 0.05). Incidences of pulmonary infection, atelectasis, and arrhythmia were not statistically different between the two groups (P > 0.05). However, hemoptysis and pulmonary air leakage (>3d) occurred significantly less frequently in the 3D than in the 2D group (P < 0.05).Conclusion3D‐CTBA‐VATS is a more accurate and smooth technique and leads to reduced intraoperative and postoperative complications.