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Journal Thoracic of Disease Vol 8, No 4 April 2016 ISSN 2072-1439 JJOURNALOURNAL ofof TTHORACICHORACIC DDISEASEISEASE jtd.amegroups.com FOCUSED ISSUE: Thymic Malignancy—Perspectives from the Chinese Alliance for Research in Thymomas (ChART) Guest Editor: Wentao Fang Volume 8 NomberVolume 4 April Pages 640-743 2016 The Official Publication of ATION RE IT PO C R L T A S N 2 R 0 U 2014 1 O 5 J IMPACT FACTOR Indexed in 1.783 © S T R THE FIRST AFFILIATED HOSPITAL OF GUANGZHOU MEDICAL UNIVERSITY H E OM T SON REU PubMed, SCI EDITOR-IN-CHIEF: TRISTAN D. YAN Aims and Scope Guangzhou office: The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: Guangqiao Zeng, MD 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, Guangzhou Institute of Respiratory Disease & The First indexed in PubMed/PubMed Central in Dec 2011, and Science Affiliated Hospital of Guangzhou Medical University. Citation Index (SCI) on Feb 4, 2013. It is published quarterly No. 151, Yanjiang Rd, Guangzhou 510120, China. (Dec 2009- Dec 2011), bimonthly (Jan 2012- Dec 2013), and monthly (Jan 2014-), and openly distributed worldwide. JTD Email: [email protected] publishes manuscripts that describe new findings in the field jtd.amegroups.com to provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease (lung Note to NIH Grantees disease, cardiac disease, breast disease and esophagus disease). Pursuant to NIH mandate, AME Publishing Company will post the Original articles are considered most important and will be accepted version of contributions authored by NIH grant-holders processed for rapid review by the members of Editorial Board. to PubMed Central upon acceptance. This accepted version will Clinical trial notes, Cancer genetics reports, Epidemiology be made publicly available 2 months after publication. For further notes and Technical notes are also published. Case reports information, see www.amepc.org implying new findings that have significant clinical impact are carefully processed for possible publication. Review articles Conflict of Interest Policy for Editors are published in principle at the Editor’s request. There is no fee The full policy and the Editors’ disclosure statements are involved throughout the publication process. The acceptance of available online at: jtd.amegroups.com the article is based on the merit of quality of the manuscripts. All the submission and reviewing are conducted electronically Disclaimer so that rapid review is assured. The Publisher and Editors cannot be held responsible for errors or any consequences arising from the use of information The Official Publication of: contained in this journal; the views and opinions expressed do not v Guangzhou Institute of Respiratory Disease (GIRD) necessarily reflect those of the Publisher and Editors, neither does v China State Key Laboratory of Respiratory Disease the publication of advertisements constitute any endorsement by v First Affiliated Hospital of Guangzhou Medical University the Publisher and Editors of the products advertised. v Society for Thoracic Disease (STD) Cover Image: Endorsed by: A tumor attenuation is considered homogeneous or v International COPD Coalition (ICC) heterogeneous (See P648 in this issue). Editorial Correspondence For submission instructions, subscription and all other HK office: information, please visit jtd.amegroups.com Daoyuan Wang. AME Publishing Company © 2016 Journal of Thoracic Disease Room 604, 6/F Hollywood Center, 77-91 Road, Sheung Wan, Hong Kong. Editor-in-Chief Executive Editor-in-Chief Executive Editor-in-Chief Nanshan Zhong, MD Jianxing He, MD, FACS (Cardiovascular Surgery) Academician, Chinese Academy of Engineering. Department of Cardiothoracic Surgery, The Tristan D. Yan, BSc, MBBS, MS, MD, PhD Guangzhou Institute of Respiratory Disease, First Affiliated Hospital of Guangzhou Medical Department of Cardiothoracic Surgery, Royal Guangzhou, China University, Guangzhou, China Prince Alfred Hospital, University of Sydney, Sydney, Australia; The Collaborative Research (CORE) Group, Sydney, Australia Associate Editors-in-Chief Kwun Fong, MBBS (Lon), FRACP, PhD Editorial Co-Directors & Executive Editors Rongchang Chen, MD, PhD Brisbane, Australia Guangqiao Zeng, MD Guangzhou, China Lawrence Grouse, MD, PhD Guangzhou, China Alessandro Brunelli, MD Gig Harbor, USA Daoyuan Wang, MD Leeds, UK Shahzad G. Raja, MBBS, MRCSEd, FRCSEd (C-Th) Guangzhou, China Jin-Shing Chen, MD, PhD London, United Kingdom Taipei, Taiwan Gaetano Rocco, MD, FRCS (Ed), FETCS, FCCP Yi-Jen Chen, MD, PhD Naples, Italy Duarte, USA Wentao Fang, MD Kian Fan Chung, MD, DSc, FRCP Shanghai, China London, UK Statistical Editors Associate Editors Gary Y. Yang, MD Jiqian Fang, PhD Hatem A Azim Jr, MD Loma Linda, United States Guangzhou, China Brussels, Belgium Paul Zarogoulidis, MD, PhD Baoliang Zhong, MD, PhD Keneng Chen, MD, PhD Thessaloniki, Greece Hong Kong, China Beijing, China Junya Zhu, PhD Kazuaki Takabe, MD, PhD, FACS Baltimore, United States Richmond, United States Editorial Board Markus Krane, MD Akio Niimi, MD, PhD Peter J Barnes, DM, DSc, FRCP, FCCP, FMedSci, Alexander Sasha Krupnick, MD Paul O’Byrne, MB, FRCP(C), FRSC FRS Anand Kumar, MD Antonio Passaro, MD J. Patrick Barron, MD Aseem Kumar, PhD Kostas Papagiannopoulos, MD, MMED Luca Bertolaccini, MD, PhD, FCCP Kefang Lai, PhD, MD THORAX, (CTH) Weiguo Cao, MD Y. C. Gary Lee, MBChB, PhD, FCCP, FRCP, FRACP Georgios Plataniotis, MD, PhD Stephen D. Cassivi, MD, MSc, FRCSC, FACS Jang Ming Lee, MD, PhD David Price, M.B B.Chir, MA, DRCOG, FRCGP Mario Cazzola, MD Harish Mithiran Muthiah, MBBS, MRCSEd, Gui-bin Qiao, MD, PhD Joe Y Chang, MD, PhD FRCSEd(CTh) Klaus F Rabe, MD, PhD Anne Chang, MBBS, FRACP, PhD, FAAHMS Mario Leoncini, MD Dominik Rüttinger, MD, PhD, FACS Wanqing Chen, MD Toni Lerut, MD Martin Schweiger, MD Lawrence H. Cohn, MD Hui Li, MD Suresh Senan, MRCP, FRCR, PhD Henri G. Colt, MD, FCCP Min Li, PhD, Professor Alan Dart Loon Sihoe, MBBChir, MA (Cantab), Wendy Cooper, PhD Tianhong Li, MD, PhD FRCSEd (CTh), FCSHK, FHKAM (Surgery), FCCP Thomas A. D’Amico, MD Wenhua Liang, MD Charles B. Simone, II, MD Keertan Dheda, MBBCh (Wits), FCP, FCCP, Moishe Liberman, MD, PhD, FRCSC, FACS Yong Song, MD, PhD PhD (Lond), FRCP (Lond) Yang Ling, MD Lorenzo Spaggiari Peter V. Dicpinigaitis, MD Chia-Chuan Liu, MD Joerg S. Steier, MD (D), PhD (UK) Leonardo M. Fabbri Deruo Liu, MD Xiaoning Sun, MD, PhD Yoshinosuke Fukuchi, MD, PhD Lunxu Liu, MD Lijie Tan, MD, Vice Chief Diego Gonzalez-Rivas, MD, FECTS Yue Liu, MD Kosmas Tsakiridis, MD, PhD Dominique Gossot, MD Hui-Wen Lo, PhD Mark I. van Berge Henegouwen, MD, PhD Cesare Gridelli, MD Kevin W. Lobdell, MD Federico Venuta, MD Bing Gu, MD Jiade J. Lu, MD, MBA Ko Pen Wang, MD, FCCP Henrik Jessen Hansen, MD Wei-Guo Ma, MD Qun Wang, MD, FRCS Don Hayes Jr, MD, MS, Med Atul Malhotra, MD Yi-Xiang Wang, MD Fernando Hiran, MBBS,FRCS Giovanni Mariscalco, MD, PhD Zheng Wang, MD Andrea Imperatori, MD Stuart Mazzone, PhD Xin Shelley Wang, MD, MPH Mary Sau Man Ip, MBBS(HK), MD(HK), Doug McEvoy, MBBC, FRACP Bryan A Whitson, MD, PhD FRCP (London, Edinburgh, Glasgow), FHKCP, Andrew McIvor, FRCP(C), FRCP(Edin), Yunlong Xia, MD, PhD FHKAM, FAPSR, FCCP MRCP(UK), FACP, FCCP Jin Xu, MS Rihard S. Irwin, MD, Master FCCP Walter McNicholas, MD, FRCPI, FRCPC, FCCP Chong-Jen Yu, MD. PhD. Mahmoud Ismail, MD Michael T. Milano, MD, PhD Junfeng (Jim) Zhang, PhD David R. Jones, MD John D. Mitchell, MD Lanjun Zhang, MD, PhD Ki-Suck Jung, MD, PhD Alyn H Morice, MD Ming Zhong, MD Ahmet Kilic, MD Calvin Sze Hang Ng, BSc(Hons), MBBS(Hons), Caicun Zhou, MD, PhD Hyun Koo Kim, MD, PhD MD(Res)(Lond), FRCSEd(CTh), FCSHK, Qinghua Zhou, MD Fanny W.S. Ko FHKAM(Surg), FCCP Zhi-Hua Zhu, MD, PhD Section Editor (Director) Section Editors Section Editors (Cardiology) Bing Gu, MD Xuzhou, China (Laboratory Medicine in Thoracic Diseases) Yong-Ming He, MD, PhD Jiangsu, China Xu-Guang Guo, MS Guangzhou, China Lei Huang Tianjin, China Section Editors Zhijun Han, MD Wuxi, China Fang-Zhou Liu, MD, PhD Guangdong, China (Respiratory Medicine and Critical Care) Yiling Huang Nanjing, China Junhong Wang, MD, PhD Nanjing, China Zhilei Cui, MD, PhD Shanghai, China Erfu Xie, MD Nanjing, China Feng Zhang, MD, PhD Shanghai, China Hao Jiang Nanjing, China Ting Xu, MD Nanjing, China Hui-Ping Zhang, MD Beijing, China Hua Liu, MD, PhD Nantong, China Lixia Zhang, MD Nanjing, China Bo Liu, MD Nanjing, China Section Editors (Cardiovascular Surgery) Lei Pan, MD, PhD Binzhou, China Section Editor (Thoracic Infection Yi Lin, MD Shanghai, China Yang Wang, MD, PhD Wuhan, China Management) Buqing Ni, MD, PhD Nanjing, China Zhongheng Zhang, MM Jinhua, China Wen-Sen Chen, MD Nanjing, China Lei Zhang, MD Shanghai, China Qing Zhou, MD Shanghai, China Kai Zhu, MD, PhD Shanghai, China Section Editors (Thoracic Oncology) Tianxiang Chen, MD, PhD Shanghai, China Section Editors (Thoracic Radiology) Section Editors (Thoracic Surgery) Chen Chen, MD, PhD Changsha, China Lihua Chen Wuxi, China Gang Shen, MMSC Hangzhou, China Jie Dai, MD, PhD Shanghai, China Xi-Jian Dai Shenzhen, China Ji-ming Sha, MD Anhui, China Lei Deng, MD Chengdu, China Yaxing Shen, MD Shanghai, China Guan Jiang MD, PhD Xuzhou, China Section Editors (Thoracic Pathology) Jianfei Shen, MD Guangzhou, China Long Jiang, MBBS, MD, PhD Beijing, China Xiangshan Fan, MD, PhD Nanjing, China Gang Shen, MMSC Hangzhou, China Xiaozheng Kang, MD Beijing, China Jun-Qiu Yue, MD, PhD Wuhan, China Haifeng Wang, MD Shanghai, China Di Lu, MD Guangdong, China Dong Xie, MD, PhD