Objective To determine the effectivity of 5-azacytidine(5-Aza) inducing the cardiomyogenic SCs were isolated and purified from Sprague-Dawley (SD) rats. Some BMSCs were induced with 5-Aza,group Ⅰ was not induced with 5-Aza and the third generation of cells were used for the next experiment; group Ⅱ were cultured and induced with 5-Aza( 10 μmol/L) at the third day of the culture for 24 h; group Ⅲ were induced with 5-Aza( 10 μmol/L) for 24 h when the third generation of cell were fused; group Ⅳ were induced with 5-Aza( 10 μmol/L) for 24h at the third day of primary cuhure,which were induced with 5-Aza( 10 μmol/L) for 24 h before the third gener-phosis was found in the BMSCs among groups. CD34 was negatively expressed and CD29 and CD44 were positively gle 5-Aza inducing group(group Ⅲ ) was much higher than that in no 5-Aza inducing group( group Ⅰ ) [ MHC : (6. 82±2.05 ) % vs (3.61±1.14) % ], cTnI: (5.63±1.86) % vs (2.76±0.82) %, P < 0.05 ], but was significantly lower than the percentage in the double 5-Aza inducing group ( group Ⅳ ) [ MHC : ( 12.18±3.16) % vs ( 6.82±2. 05)% ] ,cTni:(9.93±2.79)% vs(5.63±1.86)% ,P<0.05]. Conclusions 5-Aza could promote the cardio-myogenic differentiation of BMSCs in a "Cardiac-like" Milieu. 5-Aza double induing is better than the single indu-cing.

Ras is best known for its ability to regulate cell growth, proliferation and differentiation. Mutations in Ras are associated with the abnormal cell proliferation which can result in incidence of all human cancers. Extracellular signal-regulated kinase (ERK) is a downstream effector of Ras and plays important roles in prognosis of tumors. Recently, evidence has gradually accumulated to demonstrate that there are other effectors between Ras and ERK, these proteins interact each other and constitute the thorough Ras/Raf/MEK/ERK signaling pathway. The pathway has profound effects on incidence of esophageal carcinoma and clinical applications of some chemotherapeutic drugs targeting the pathway. Further understanding of the relevant molecular mechanisms of Ras/Raf/MEK/ERK signaling pathway can be helpful for the development of efficient targeting therapeutic approaches which contribute to the treatment of esophageal cancer. In this article, roles of Ras/Raf/MEK/ERK signaling pathway in esophageal carcinoma as well as pharmacological targeting point in the pathway are reviewed.

With the popularization of low-dose computed tomography (LDCT) scanning, the rate of the diagnosis of primary lung cancer for early-stage non-small cell lung carcinoma (NSCLC) is increasing, mainly because of a growing rate of solitary pulmonary nodule and ground-glass nodule. For these patients, recent studies have shown that segmentectomy and lobectomy have similar oncologic effects, while they can retain more lung function and improve the quality of life, so anatomical segmental resection is an alternative operation. In recent years, the three-dimensional reconstruction technology based on medical imaging has developed rapidly, which can be used to understand the anatomical structure, nodule position, spatial relationship, design of surgical path and other advantages in preoperative, and plays an important role in the thoracoscopic anatomical segmental resection with complex anatomical structure and individual differences. This paper reviews the application of three-dimensional reconstruction technology in segmental lung resection, and briefly introduces the application of this technology in precise segmental lung resection.

Objective To compare the efficacy and safety of robotic lobectomy and thoracoscopic lobectomy in early stage non-small cell lung cancer. Methods From January 2016 to January 2018, 113 patients with early-stage non-small-cell lung cancer who met the inclusion criteria were included in the same surgical group of thoracic and cardiac surgery department of the first affiliated hospital of nanchang university. According to the surgical method, they were randomly divided into robot-assisted thoracoscopic surgery (57 cases) and conventional thoracoscopic surgery (56 cases). Preoperative age (± 5 years) and relevant basic medical history were used to match the patients. The lymph node ascending rate, operative time, preoperative preparation time, intraoperative blood loss, drainage time, postoperative pain score on the second day, postoperative hospitalization time and perioperative complications of the two groups were compared prospectively. Results There was no significant difference in lymph node ascending rate, operation time, pain score on the second day after surgery and lymph node clearance number between the two groups. Intraoperative blood loss, drainage time and postoperative hospitalization time were lower than that of the thoracoscopy group (P < 0.05). The complication rate of the robot group was significantly lower than that in the thoracoscopy group (10.5％ vs. 26.7％, P < 0.05). The preoperative preparation time of the robot group was higher than that of the thoracoscopic group (P < 0.05). Conclusion Robot lobectomy is better and safer in patients with early non-small cell lung cancer than thoracoscopic lobectomy, and can be used in clinical application.

Objective To promote comprehension of pulmonary sequestration by investigating the diagnosis and surgical treatment methods of this disease.Methods A retrospective analysis of the clinical records of 27 patients with pulmonary sequestration was made,15 male patients and 12 female patients,with the age ranging from 4 to 56 years old.The patients were examined by chest radiography,computerized tomography (CT),computerized tomography angiography (CTA),magnetic resonance imaging (MRI) before the surgery.Eleven patients were confirmed preoperatively as pulmonary sequestration by the contrast enhanced CT and 64slice spiral CT examinations.Sequestrectomy was performed on patients with extralobar sequest ration (ELS) and lobectomy was performed on patients with intralobar sequestration (ILS).There were 21 cases of left lower lobectomy,5 cases of right lowerlobectomy,and 1 case of right sequestrectomy.Results All recovered uneventfully.No significant complications occurred in the perioperative period.All patients were cured and discharged from hospital.No relapse was reported during follow up period.Conclusion Diagnosis mainly depended on the chest radiography,CT,MRI and CTA.Surgical operation should be the best choice of treatment.

Persistent left superior vena cava (PLSVC) with absence of right superior vena cava (SVC), also known as isolated PLSVC, is a relatively rare type of congenital body venous malformation. Isolated PLSVC is asymptomatic, however, it will bring clinical difficulties to the implantation of the totally implantable venous access port (TIVAP). We reported a 41 years, male patient with esophageal cancer, who needed neoadjuvant chemoimmunotherapy. Through doppler ultrasonography, computed tomography (CT) and vascular 3D-reconstruction, we found him to be a patient with PLSVC with absence of right SVC before the insertion of TIVAP. Hence, we chose the left approach in which the needle was inserted into the sternocleidomastoid clavicular head lateral notch in left supraclavicular fossa as the puncture point. The depth of the catheter tip from the root of the neck to the puncture point was 21.5 cm and the catheter tip was located at the junction of the PLSVC and the right atrium, at the dilated coronary sinus. The procedure was successful and the patient received expected neoadjuvant chemotherapy combined with immunotherapy after operation, and anticoagulant therapy was performed to prevent thrombosis in coronary sinus and superior vena cava. There was no major catheter-related complication during the period of TIVAP.

Objective     To investigate short-term outcomes of robot-assisted Heller-Dor myotomy (RAHM-Dor) for achalasia of cardia and our learning curve experience. Methods     The clinical data and recent follow-up results of 42 patients who received RAHM-Dor from November 2015 to January 2020 in the Department of Thoracic Surgery of the First Affiliated Hospital of Nanchang University were retrospectively analyzed, including 20 males and 22 females with a mean age of 40.8±18.4 years. Results    Dysphagia was the most common symptom, followed by heartburn and regurgitation. The mean operation time was 122.8±23.9 min. The mean blood loss was 47.5±32.7 mL. Two patients suffered mucosal injury, and successfully repaired by suturing during surgery. There was no esophageal fistula, conversion to an open operation or perioperative death in this series. The median length of hospital stay was 8 (6, 9) d. In all patients, the Stooler and Eckardt scores of postoperative 1, 6 and 12 months decreased compared to those of pre-operation (P<0.001). Conclusion     RAHM-Dor is a safe and feasible avenue for the treatment of achalasia of cardia, and can achieve a satisfying short-term results. The learning curve shows a transition to the standard stage from the learning stage after 16-18 operations.