KLF9(Kruppel-likefactor9)isthetranscriptionfactorthatcanbindGC-richsitesthrough three C2H2-type zinc fingers and can regulate diverse biological processes,including cell proliferation,apopto-sis and the development of the organ.KLF9 is downregulated in some tumor specimens and tumorous cell lines relative to the normal samples and cell lines and plays an important role in the growth of cancer cells.Similar with the other KLF numbers,KLF9 could affect the development of tumors,especially for the endocrine-related cancers through multiple signaling pathways and interventions with other proteins.

Objective:To analyze the factors affecting lymph node failure pattern after radiotherapy/chemotherapy in esophageal squamous cell carcinoma without initial clinical metastasis. Methods:A total of 263 patients, who were diagnosed as thoracic esopha-geal carcinoma from January 2002 to December 2009, were included in this retrospective study. Factors affecting lymph node failure pattern with general clinical data and tumor local factors were analyzed. Results:Among the 263 esophageal cancer cases, 31 (11.8%) had lymph node metastasis after treatment, including 18 cases of simple lymph node metastasis and 13 other cases of lymph node metas-tasis with esophageal and other organ metastasis or recurrence. The numbers of cases for lymph node metastasis in the upper, middle, and lower thoracic esophagus were 11 (13.3%), 13 (10.1%), and 7 (13.7%), respectively. Univariate analysis showed that recent cura-tive effect, length of tumor on X-rays, maximum tumor diameter, and tumor volume were the significant factors associated with lymph node metastasis (χ2=7.597, 9.717, 5.361, and 4.815;P=0.006, 0.002, 0.021, and 0.028). Logistic regression analysis results showed that recent curative effect and length of tumor on X-rays were independent significant factors (P=0.004 and 0.026). Conclusion:Recent cu-rative effect and length of tumor on X-rays were the significant factors associated with lymph node failure pattern after radiotherapy/chemotherapy in esophageal squamous cell carcinoma without initial clinical metastasis.

Objective To determine the surgical procedures and effects of ultra-distal tibial intramedullary nails combined with blocking screws in treatment of distal tibial fractures.Methods From April 2008 to September 2012,21 cases of distal tibial fractures were treated with ultra-distal tibial intramedullary nails combined blocking screws.All fractures were statically locked and closed using undreamed technique.For relatively simple fracture,blocking screws were considered when the reduction and stability was not satisfied after the insertion of intramedullary nails; for severe comminuted fractures,blocking screws were inserted directly under C-arm fluoroscopy.Partial weight-bearing was permitted 3 weeks after surgery.Quality of reduction,fracture union,and function assessment were measured at follow-up.Results No skin necrosis and soft tissue and bone infections occurred after a mean follow-up of 17.5 months (range,12-22 months).All fractures were healed with an average healing time of 12 months (range,8-26 months).X-ray findings revealed the fracture of ＜ 5° angulation on coronal and sagittal planes.There was no deformation or breakage of blocking screws and intramedullary nails.According to the criteria of Tormetta,the results were excellent in 19 cases and good in 2.Conclusion Blocking screws assists reduction and improve the fixation stability by narrowing the canal in treatment of distal tibial fractures and expands the application of intramedullary nails.

Objective To determine the clinical effects of type Ⅲ biliary atresia treated by hepatojejunostomy (Kasai procedure).Methods A retrospective study was performed on patients with type Ⅲ biliary atresia treated in our hospital between January 2009 to December 2013.Results The follow-up data were completed in 42 patients out of 48 patients (87.5％) who underwent Kasai procedure for type Ⅲ biliary atresia.The jaundice disappeared in 31 of 42 patients (73.8％).The rate of patients having cholangitis was 47.6％.There were significant differences in the 2-year survival among the groups of patients with mild cholangitis (75.0％,9/12),serious cholangitis (25.0％,2/8) and without cholangitis (86.4％,19/22) (P ＜ 0.05).Conclusions Hepatojejunostomy (Kasai procedure) is an effective operation to treat type Ⅲ biliary atresia.Our data suggested that the survival rates were related to the degree of bile drainage and cholangitis post surgery.

Objective:To investigate the therapeutic range of tacrolimus and effects of tacrolimus on liver and re- nal functions and blood routine in renal transplant recipients.Method:The whole blood tacrolimus concentration was meas- ured by micro-particle enzyme immunoassay(MEIA).Blood tacrolimus concentrations in 390 cases of renal transplant re- cipients were analyzed.The effects of tacrolimus on liver and renal function and blood routine were also studied.Result: The blood tacrolimus concentrations in 377 of 390 cases were within the range from 3 to 15?g?L~(-1).Their blood tacrolimus concentration differed greatly in renal transplant recipients within 6 months after transplantation.Their blood tacrolimus concentration was gradually decreased as time went on.Tacrolimus with therapeutic dosage had no effects on liver and renal function and blood routine.Conclusion:The therapeutic ranges of tacrolimus with MEIA were as follows:5 to 15?g?L~(-1) within 3 months after transplantation,5 to 10?g?L~(-1)between 4 to 6 months after transplantation,3 to 10?g?L~(-1)6 months after transplantation.The administration of tacrolimus had no effects on the liver and renal function and blood routine in re- nal transplant recipients.

Background Researches showed that triterpenoids,with a similar structure to lanosterol,has therapeutical effect on many systemic diseases,and lanosterol was determined to have a therapeutical effect on cataract recently.However,how the lanosterol plays effects on other eye diseases is still unelucidated.Understanding the distribution of lanosterol in ocular tissue is helpful for us to elucidate the relationship of lanosterol with eye diseases.Objective This study attempted to investigate the distribution of lanosterol synthase (LSS) and lanosterol in cornea,lens and retina tissue of rats and offer a basis for the targeting treatment of eye diseases.Methods Fifteen SPF male SD rats were sacrificed by excessive anesthesia to obtain the eyeballs.The relative expressions of LSS protein and gene in the cornea,lens and retina tissue of the rats were detected by Western blot and reverse transcription (RT)-PCR,respectively.Immunofluorescence staining technology was used to locate the distribution of LSS in cornea,lens and retina tissue.The contents of lanosterol in the cornea,lens and retina tissue were analyzed by liquid chromatograph mass spectrometer (LC-MS).Results No LSS protein and mRNA was expressed in the retinal tissue in normal rats.The mean relative expression of LSS protein in the lens and cornea was 0.43±0.05 and 0.25±0.03,respectively,showing a significant difference between them (t =-5.35,P＜ 0.01).The relative expression of LSS mRNA was 0.51 ±0.04 and 0.29 ±0.02 in the lens and cornea,respectively,with a stronger expression in the lens in comparison with the cornea (t =-8.34,P＜0.01).Immunofluorescence staining showed that LSS primarily located in corneal epithelial layer,stromal layer and endothelial layer as well as lens epithelial cells and shallow cortex layer and hardly expressed in retina,and no co-expression of LSS with the neuron marked by NeuN and the Müller cell marked by glutamine synthetase (GS) in retinal tissue.LC-MS analysis revealed that the contents of lanosterol in lens and cornea was (24.37 ±2.91) ng/mg and (5.31 ±0.58) ng/mg,respectively,with a significant difference between them (t =-11.13,P＜0.01).Conclusions LSS and lanosterol extensively distribute in cornea and lens of normal rats,but not in retina tissue.These results offer new strategies for the target treatment of relevant eye diseases.

Many studies have shown that abnormal expression and modification of lamin are closely related to aging.Hutchinson-Gilford progeria syndrome(HGPS)is a rare and severe premature aging disease caused by mutations in the gene encoding nuclear envelope proteins of A-type lamins (LMNA).The pathogenesis of HGPS is similar to the aging process of normal individuals,thus research on HGPS will be helpful for understanding the mechanisms of senescence and developing antiaging drugs.This paper reviews recent advances in lamin and the pathogenesis and treatment of HGPS,in order to provide a reference for further basic and clinical research on HGPS.

Background and objective Postoperative pulmonary complications (PPCs),especially postoperative pneumonia (POP),directly affect the rapid recovery of lung cancer patients after surgery.Peak expiratory flow (PEF) can reflect airway patency and cough efficiency.Moreover,cough impairment may lead to accumulation of pulmonary secretions which can increase the risk of PPCs.The aim of this study is to investigate the effect of preoperative PEF on PPCs in patients with lung cancer.Methods Retrospective research was conducted on 433 lung cancer patients who underwent lobectomy at the West China Hospital of Sichuan University from January 2014 to December 2015.The associations between preoperative PEF and PPCs were analyzed based on patients' basic characteristics and clinical data in hospital.Results Preoperative PEF value in PPCs group (280.93±88.99) L/min was significantly lower than that in non-PPCs group (358.38±93.69) L/min (P＜0.001).According to the binary logistics regression analysis,PEF and operative time were independent risk factors for PPCs.Further,ROC curve showed that PEF=320 L/min was the cut-off value for predicting the occurrence of PPCs (AUC=0.706,95％CI:0.661-0.749).The incidence of PPCs in PEF≤320 L/min group (26.6％) was significantly higher than that in PEF＞320 L/min group (9.4％)(P＜0.001).Conclusion Preoperative PEF and PPCs are correlated,and PEF maybe used as a predictor of PPCs.

The rapid development and promotion of minimally invasive thoracic surgery represented by video-assisted thoracoscopy surgery has gradually replaced traditional thoracic surgery technique as the primary choice for the treatment of pulmonary nodules, including early lung cancer. With the clinical application of double-lumen bronchial catheters, the realization of one-lung ventilation technology not only provides a solid anesthesia foundation for the popularization of minimally invasive thoracic surgery, but also provides a guarantee for the rapid and smooth implementation of the operation. However, compared with single-lumen bronchial catheters, the diameter of the double-lumen bronchial catheter is thicker, and the tube body is hard and difficult to shape, which brings inconvenience to anesthesia intubation. The bronchial structure is different, and the incidence of dislocation during anesthesia intubation is also high. With the gradual clinical use of video double-lumen tube (VDLT), it has become a hot spot in thoracic surgery in recent years. This article reviews the application and research progress of VDLT in thoracic surgery.
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Humans ; Intubation, Intratracheal/methods* ; Lung Neoplasms/surgery* ; One-Lung Ventilation/methods* ; Thoracic Surgery ; Thoracic Surgery, Video-Assisted/methods*