Objective To investigate the clinical efficacy, the toxicity and side reactions of interventional chemoembolization with FOLFOX4 regimen through both hepatic artery and superior mesenteric artery, i.e. dual access technique, in treating primary hepatocellular carcinoma. Methods Between November 2010 and March 2013 at authors’ hospital, a total of 21 patients with advanced primary hepatocellular carcinoma (the study group) were treated with FOLFOX4 regimen by using dual access interventional technique. FOLFOX4 regimen included hepatic arterial infusion of 5-fluorouracil 400 mg/m2, hepatic arterial chemoembolization with iodipin and oxaliplatin 85 mg/m 2, intravenous administration of calcium folinate 200 mg/m2 IV on the first and second day, trans-superior mesenteric artery continuous infusion (lasting for 22 hours) of 5 -Fuorouracil 600 mg/m2 on the first and second day. During the same period other 21 patients with primary hepatocellular carcinoma were selected (used as the control group) to receive conventional hepatic arterial chemoembolization. In both groups, the treatment was repeated after 4-6 weeks. The therapeutic effect and the toxicity and side reactions were evaluated after the second treatment. Results The effective rate for the study group and the control group was 61.9% and 28.6% respectively, and the median survival time for the study group and the control group was 14.7 months and 9.4 months respectively. The differences in the effective rate and the median survival time between the two groups were statistically significant (P = 0.030 and P = 0.034). The occurrence of toxicity and side reactions, such as digestive tract reactions and the damage of liver function, in the study group were strikingly lower than those in the control group. Conclusion Through dual approach of hepatic artery and superior mesenteric artery catheterization, interventional chemoembolization with FOLFOX4 regimen is outstandingly effective for primary hepatocellular carcinoma, meanwhile, the side effects are very slight.

To observe the expression of CD40/CD40L on peripheral blood mononuclear cells (PBMC) in patients with condyloma acuminatum (CA), flow cytometry was employed to examine the expression of CD40 and CD40L on PMBC in 36 patients with CA and 20 healthy controls. Our results showed that mean level of CD40 expression in CA patients was significantly lower than that in the controls (6.58% +/- 2.74% vs 14.81% +/- 6.12%, t = 5.703, P < 0.05); the average level of CD40L in CA patients was also significantly lower than that in the controls (0.73% +/- 0.54% vs 2.67% +/- 2.43%, t = 3.532, P < 0.05). Our results suggest that the reduced costimulatory interaction of CD40 and CD40L in CA patients may be one of the important factors responsible for the low cellular immunity.

Objective To compare the efficacy of lymph nodes(LNs) dissection between video-assisted thoracic surgery (VATS) and thoracotomy in the treatment of clinical stage Ⅰ lung cancer.Methods A comprehensive search of PubMed,Ovid Medline,EMBASE,Web of Science,ScienceDirect,the Cochrane Library,Scopus database and Google Scholar was performed to identify studies comparing VATS and thoracotomy in LNs dissection.The data was analyzed by RevMan 5.3 software and SPSS 18.0.Results After selection,23 articles met the inclusion criteria.2 316 patients were involved in VATS group and 3 346 patients were involved in Open group.Meta analysis showed that less total LNs(95％ CI:-1.64--0.60,P ＜ 0.0001),totalLNsstations(95％CI:-0.61--0.01,P=0.04) andN1 LNs(95％CI:-0.28--0.02,P=0.02)were dissected in VATS group.On the left side,more LNs were dissected in VATS group(95％ CI:0.51-3.22,P =0.007).The same number of mediastinal LNs (95％ CI:-0.74-0.15,P =0.20),mediastinal LNs stations (95％ CI:-0.20-0.14,P =0.76),right side LNs (95 ％ CI:-1.52-2.23,P =0.71) were harvested in both groups.Conclusion In the surgical treatment of clinical stage Ⅰ lung cancer,less total LNs,total LNs stations and N1 LNs were dissected in VATS group,while more left side LNs were harvested by VATS.The same number of mediastinal LNs,mediastinal LNs stations right side LNs were harvested in the two groups.This conclusion still needs to be further proved by more high-quality and large-scale RCTs.

BACKGROUND: Rehabilitation exercise and conservative treatment do not bring about good therapeutic effect for severe obstructive emphysema.And lung volume reduction surgery (LVRS) is an effective method for this kind of disease. How much emphysematous tissue should be resected in LVRS to achieve the best curative effect has been a concern.OBJECTIVE: To evaluate the pulmonary functional and alveolar morphologic changes in emphysematous rabbits after unilateral LVRS, and to compare the effects of different resection volumes.DESIGN: A completely randomized and controlled trial.SETTING: Thoracic Surgery Center of Daping Hospital of the Third Military Medical University of Chinese PLA.MATERIALS: This study was completed at the Laboratory of Thoracic Surgery Center of Daping Hospital of the Third Military Medical University of Chinese PLA from Frebruary 2003 to August 2003. Totally 50 New Zealand white male rabbits of cleaning grade were involved. These animals were divided randomly into groups of emphysema (A), less volume LVRS (B), middle volume LVRS (C), larger volume LVRS (D), and shame operation (E) .METHODS: Making of the rabbit emphysema model: Rabbits were put into an organic glass box and they inhaled passively smog produced from the cigarettes. Within seven weeks, 15 cigarettes (Yinxiang .Brand) were lighted for about 30 minutes every time, once per day and five times a week. Elastase for 3 mL(2000 U/kg) from porcine pancreas (SERVA Co.,Ltd) was injected into the rabbits' trachea in the fourth week. Intervention for different groups: Rabbits in Group A received no operation at all. Animals in other four groups were given general anesthesia by muscular injec tion of Sumianxin Ⅱ and they were then fixed supinely on the operation table. The rabbits were intubated with a 3-mm endotracheal tube and mechanically ventilated (HX-200 ventilator) with a tidal volume of 12 mL/kg and a respiratory rate of 40-50/minute. Thoracotomy was conducted through anterolateral incision of the fourth right intercostals area. The upper and lateral pulmonary tissues of the first lobe of the right lung were resected in Group B. For group C, the upper and lateral pulmonary tissues of the first and the second lobes of the lung were resected. For Group D, the upper and lateral pulmonary tissues of the first, second and the third lobes of the right lung were resected. The pulmonary removal was about a half of the total volume of the lobe. The specimens were removed, followed by 3-0 mattress suture of the wounds. Then, fibrin sealant was insufflated to avoid air leakage after the operation. Thoracotomies without any resection of lung parenchyma were carried out in Group E. Histologic inspection and quantitatively morphologic analysis of the left lung was postoperatively carried out eight weeks later.MAIN OUTCOME MEASURES: Quantitative analysis of pulmonary functions and alveolar morphology in rabbits with emphysema after lung volume reduction surgery with different resection volumes RESULTS: All the fifty rabbits were analyzed, and there were ten animals in each group. ① Comparison of ventilation volume in each group: In Group C, vital volume (VT), forced expiratory volume in 0.3 s (FEV0.3),FEV0.3/forced expiratory capacity (FVC) were all higher than those of Group A [(6.69±0.83) mL, (6.39±1.35) mL, (64.5±16.1)％; (5.76±0.84) mL,(5.23±1.37)mL, (50.2±15.6)％, P＜ 0.05], while functional residual capacity (FRC) was lower than that in group A [(14.3±1.9)mL; (19.3±3.1)mL, P＜ 0.05].Compared with Group A, no obvious difference in the above lung functions of Groups B, D and E was observed (P ＞0.05). ② Histopathological observation results: In group C, obvious repairs to dilatation and destruction of alveolar ducts or cyst were observed and the aggregation of macrophage and neutrophils in the end-terminal bronchiole decreased. In Group D, the inflammatory cells decreased, but alveolar destruction and dilatation became more marked. ③Comparison of the total lung capacity (TLC): TLC of Group C was less than that of group A [(42.1 ±5.8)mL, (58.5±7.6)mL, P＜ 0.05].Compared with group A, no obvious difference in the above lung functions of Groups B, D and E was observed (P ＞0.05). ④ Quantitative analysis result of alveolar morphology: The number of alveoli (Na) and density of alveolar septum (Ds) in Group C were much larger than those of group A [(17.6±3.1)/field, (18.6±2.1)％; (11.3±2.7)/field, (15.2±3.6)％, P＜ 0.05] while the diameter of the alveoli (Da) in Group C was significantly lower than those of Group A[(78.1±7.1),(93.4±10.2)μm, P ＜ 0.05].CONCLUSION: Combination of smog and elastase successfully induced rabbit model of obstructive emphysema. Unilateral LVRS could improve emphysematous rabbits' pulmonary functions. Improved in pulmonary functions was not obvious by LVRS with less (12.5％) or larger (37.5％) resection volume of lung parenchyma. LVRS with appropriate resection volume (25％) could effectively eliminate airway inflammation, alleviate alveolar dilatation and destruction of the residual lung parenchyma, and thus improve pulmonary ventilation function.

Objective To investigate the effect of miR-200a on the migratory ability of NSCLC cells and to explore its possible mechanism.Methods Real-time PCR was performed to analyze the miR-200a expression in NSCLC cell lines A549 and SK-MES-1, and human normal lung bronchial epithelial cell line 16HBE.Hsa-miR-200a mimics, NC mimics, hsa-miR-200a inhibitor and NC inhibitor were transfected into A549 cells using Lipofectamine 2000.Migration of A549 cells was detected by Transwell migration assay.The potential target genes of miR-200a were predicted by bioinformatics software and then verified by dual luciferase reporter gene assay and Western blot.Results MiR-200a was significantly down-regulated in A549 and SK-MES-1 cells(P＜0.05).Exogenous over-expression of miR-200a mimics significantly inhibited migratory a-bility of A549 cells, while over-expression of miR-200a inhibitor generated the opposite effect(P＜0.01).Dual luciferase re-porter assay indicated that miR-200a could directly affect the 3'-UTR of Sulf2 gene to inhibit luciferase activity.Western blot revealed that miR-200a expression could significantly reduce Sulf2 protein expression level in A549 cells.Ectopic expression of Sulf2 protein in miR-200a-overexpressing A549 cells overrode the migration inhibition effect of miR-200a, suggesting that targe-ting Sulf2 represents an important mechanism of the anti-tumour activity of miR-200a in lung cancer.Conclusion MiR-200a inhibits migration of lung cancer cells by targeting Sulf2.

OBJECTIVE: To examine the effect of different reduced caloric intake on mice transplanted with S180 ascitic tumor. METHODS: The institute for cancer research (ICR) mice were randomly divided into control group, 3.0 standard feed (SF) group, 2.0 SF group and 1.3 SF group. The mice in control group were fed enough (about 5 g/d) dietary intake, while the amounts of dietary intake in the latter three groups were scaled down in the proportion of 65%, which were 3.0 g, 2.0 g and 1.3 g standard feed respectively. Meanwhile the essential vitamins were added to the latter three groups to keep the amount of intake the same as that of the control's. RESULTS: For most of the mice, the caloric intake obviously prolonged the mean survival days and improved the life quality was 7.14 kcal/d, and the fasting blood glucose level was 2-3 mmol/L. CONCLUSION: Properly reduced caloric intake and keeping lower blood glucose level is beneficial to prolonging the survival time of mice transplanted with S180 ascitic cancer.

Objective Describes the changes of arterial blood gas analysis and pulmonary functions of emphysematous rabbits after unilateral and bilateral lung volume reduction surgery.Methods Sixty rabbits were randomly and equally divided into 6 groups:control group(A),emphysema group( B),unilateral sham operation group(C),unilateral lung volume reduction surgery group( D),bilateral sham operation group( E ) and bilateral lung volume reduction surgery group(F).Obstructive emphysema was induced with somg and papain in tie rabbits of the remaining groups except the control one.Eight weeks later,arterial blood gas analysis and pulmonary functions were detected.Results Compared with group B,pH,PaO2,PaCO2,SaO2,forced expirratory volume in 0.5 s,froced expiratory capacity,functional residual capacity,total lung capacity,dynamic compliance,and resistance in expiartory phase could be improved in group D ( P ＜ 0.05 ).The amelioration of those results were more obvious in group F ( P ＜0.05).Two rabbits in group F died after opertation.Conclusion Bilateral lung volume reduction surgery could more markedly improve the arterial blood gas analysis and pulmonary functions of emphysematous rabbits than unilateral operation.

Objective To evaluate the feasibility and safety of uniportal Video-assisted thoracoscopicsurgery(VATS) anatomic segmentectomy for lung diseases.Methods We performed a retrospective review of 52 patients undergoing uniportal VATS anatomic segmentectomy from Mar 2015 to Dec 2015.There were 16 males and 36 females with a mean age of 52.7 years (32-82 years).The incision,about 4 to 5 cm long,is performed at the fourth or the fifth intercostal space.The camera and the instruments are all through the single incision.Results Fifty-one patients underwent uniportal VATS segmentectomy successfully.1 patient with extensive pleural adhesion was needed for auxiliary incision.The median operative time was 125 min (60-240 min),the median blood loss in operation was 60 ml (10-300 ml),the median hospital stay after operation was 4.6 days(2-14 days).There was no perioperative mortality.Major morbidity occurred in 7 patients(13.5％).Pathological examination showed that there were 10 cases of benign diseases and 42 cases of non-small cell lung cancer(26 cases of carcinoma in situ and micro invasive adenocarcinoma,16 cases of infiltrating adenocarcinoma,mucinous adenocarcinoma and carcinoid).Conclusion Uniportal VATS segmentectomy has the advantage of less intercostal nerve injury and good operative perspective.It is a safe and feasible procedure after surgery practice.

Objective To examine the prevalence of chikungunya virus in brain tissue samples from rat?like animals in Xiamen, Shenzhen and Guangzhou, and to explore whether the rat?like animals are potential sources of human chikungunya fever infections and the host of the virus. Methods Rat?like animals were trapped in residential areas, city parks, hospitals, markets and schools in Xiamen, Shenzhen and Guangzhou (Yuexiu and Baiyun districts) between January 2013 and June 2016. Brain tissue samples of the trapped animals were collected under sterile. Chikungunya virus was detected by using reverse transcription polymerase chain reaction (RT?PCR). Results Totally 1092 rat?like animals were trapped, which belonged to 7 species, 3 genera, 2 families, 2 orders. Rattus norvegicus was the dominant species in the indoor environment, Rattus losea was dominant in wild environment, and 1092 brain tissue samples were collected. No detectable chikungunya virus was found in the brain tissue samples by RT?PCR. Conclusion There is a low possibility that rat?like animals act infectious sources of human chikungunya fever infections and the host of the virus.