Purpose:To evaluate the efficiency of mediastinal lymph nodes dissection (MLND) and to determine a reasonable extent of dissection in the treatment of patients with clinical stageⅠ A non small cell lung carcinoma (NSCLC). Methods:From January 1988 to June 1995, one hundred and forty seven patients with clinical stageⅠ A NSCLC were treated by surgery. All the patients were divided into three groups according to the type of procedure, that is, resection without MLND, resection with selective MLND and systematic MLND. According to their clinical characteristics patients in each group were matched and assigned once again, and 93 cases were enrolled. Survival rates were calculated by Kaplan meier method and survival curves were prepared and survival difference was compared by Log rank test. Results:Survival rates at 5 year of no MLND, selective MLND and systematic MLND groups were 22.6%, 48.4%, and 51.6%, respectively. Survival rates of two MLND groups were higher than that of no MLND group. Log rank test presented significantly statistical difference between them ( P

Objective To explore the potential influence of a high-fat meal on systemic inflammation and fibrinolytic dysfunction in normocholesterolemic patients with essential hypertension(EH).Methods Plasma concentrations of lipids profiles,high-sensitivity C-reactive protein(hsCRP),plasminogen activator inhibitor type 1(PAI-1)and tissue plasminogen activator(t-PA)antigens in fasting state(F)and at 4 hours after a single high-fat meal(P)were measured in 54 EH patients and 30 healthy controls(Con).Results Postprandial triglyceride concentrations increased significantly in both hypertensive patients and healthy controls(P

BACKGROUNDTo elucidate the characteristics and metastastic pattern of skipping mediastinal lymph node metastasis (skipping N2) in non-small cell lung cancer (NSCLC), and investigate reasonable extent of lymph node dissection.

METHODSFrom 1990 to 1998, lobectomy combined with systematic mediastinal lymph node dissection was performed in 109 patients with NSCLC. A retrospective study was carried out to elucidate the characteristics of skipping N2 disease and to compare the difference between skipping N2 and non-skipping N2 diseases.

RESULTSTwenty-one patients (19%) had skipping N2 diseases. Of the skipping N2 group, 18 cases (86%) were adenocarcinoma. Skipping N2 disease was more common in T1 and T2 group than that in T3 and T4 group (P < 0.01). All skipping N2 diseases only involved one nodal station, and most of them were regional mediastinal nodal metastasis. Skipping N2 from upper lobe tumors mainly involved superior tracheobronchial or subaortic lymph nodes, and skipping N2 from lower lobe tumors involved subcarinal lymph nodes.

CONCLUSIONSSkipping N2 disease presents certain clinical characteristics and metastastic pattern, and mediastinal nodal dissection might be modified according to the pattern.

OBJECTIVETo investigate gene diagnosis of occult micrometastasis in the mediastinal lymph node in patients with non-small cell lung carcinoma (NSCLC) and to evaluate its prognostic significance.

METHODSWith mRNA expression of mucoid1 (MUC1) gene examined by RT-PCR, 168 mediastinal lymph nodes taken from 37 pN(0) (negative lymph nodes) NSCLC patients (stage Ia approximately IIb) made up the experiment group. Thrity negative lymph nodes from 14 benign lesions and 30 positive lymph nodes from 15 NSCLC patients served as control. The survival difference between MUC1 mRNA-negative and MUC1 mRNA-positive groups was compared by the chi(2) test.

RESULTSUC1 mRNA was not identified in the negative-control group (specificity = 100%), but it was identified in 26 of 30 positive-control samples (sensitivity = 86.7%). MUC1 mRNA was identified in 16 (9.5%) of the experiment group from 12 patients whose TNM stage was up-regulated to stage IIIa. The 3-year survival rate (58.3%) of MUC1 mRNA positive group patients with occult micrometastasis in mediastinal lymph node was lower than the 88.0% of MUC1 mRNA negative group (P < 0.05).

CONCLUSIONOccult micrometastasis in the mediastinal lymph node in NSCLC patients can be diagnosed by MUC1 mRNA expression through RT-PCR. Poor prognosis in some pN(0) NSCLC patients may be associated with nodal occult micrometastasis.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; diagnosis ; secondary ; Female ; Genetic Markers ; genetics ; Humans ; Lung Neoplasms ; diagnosis ; pathology ; Lymphatic Metastasis ; diagnosis ; Male ; Middle Aged ; Mucin-1 ; analysis ; genetics ; Prognosis ; RNA, Messenger ; analysis

BACKGROUNDTo evaluate the diagnostic method of occult metastasis to mediastinal lymph nodes (MLNs) in patients with non-small cell lung cancer (NSCLC).

METHODSThe mRNA expression of mucin 1(MUC1) gene, an epithelial-tissue-specific gene, was detected in dissected mediastinal lymph nodes by RT-PCR assay. Seventy-eight MLNs which had no malignant evidence on routine histopathologic examination were assessed in 19 patients with stage pN0-1 disease. Five regional lymph nodes from 5 patients with benign pulmonary diseases and 5 MLNs proved malignant by histopathology from 5 patients with NSCLC were also studied as negative and positive control respectively.

RESULTSThe mRNA of MUC1 was not detected in any specimen of negative control group, whereas the mRNA was detected in all MLNs of positive control group. The mRNA in 6 out of 78 MLNs from 19 patients with pN0-1 disease was also detected, and occult metastasis was diagnosed.

CONCLUSIONSDetection of MUC1 mRNA expression might be helpful to diagnose occult metastasis in MLN in patients with lung cancer, and RT-PCR is superior to routine histopathologic examination in staging NSCLC.

Objective To understand the genotypic characteristics and the neutralizing antibody levels of Japanese encephalitis virus(JEV)and Japanese encephalitis(JE)in both vector mosquitoes and in healthy people of Zhejiang province. Methods Virus was isolated from mosquitos sampled from the Monitoring Stations located in Xianju county during 2012 to 2013. Phylogenetic and homological studies were carried out on the E gene. A total of 1 263 blood specimens from 642 healthy people were collected before and after the seasons of JE epidemics. JEV neutralizing antibody was detected by the micro-neutralization test. Results Twenty-five JEV strains were isolated from a total of 11 650 mosquitoes. The identity of nucleotide appeared as 87.8%-99.7% both from 2012 to 2013 and from 1982 to 2010 while as 87.7%-88.0%with vaccine strain SA14-14-2,in Zhejiang. The phylogeny tree of E gene indicated that the newly isolated virus belonged to genotypeⅠ but no mutation of amino acid sequence coding conformational epitope was identified in the envelop protein. Both positive rates and the geometric mean titer(GMT)of neutralizing antibody in healthy people were 31.5%-42.0%and 1∶2.56-1∶3.53 in Xianju county,during 2012 and 2013,respectively. Both of the two positive rates(χ2≤1.76,P>0.05)and the two GMTs(u≤0.64,P>0.5)for antibodies pre or post the epidemic season did not show significant differences. Conclusion JEV isolated in Xianju during 2012 and 2013 belonged to genotypeⅠ. The positive rates of JEV neutralizing antibody from healthy people in Xianju were less than 42.0%,which showed no significant differendes pre or post JE epidemic season.

OBJECTIVETo understand the genotypic characteristics and the neutralizing antibody levels of Japanese encephalitis virus (JEV) and Japanese encephalitis (JE) in both vector mosquitoes and in healthy people of Zhejiang province.

METHODSVirus was isolated from mosquitos sampled from the Monitoring Stations located in Xianju county during 2012 to 2013. Phylogenetic and homological studies were carried out on the E gene. A total of 1 263 blood specimens from 642 healthy people were collected before and after the seasons of JE epidemics. JEV neutralizing antibody was detected by the micro-neutralization test.

RESULTSTwenty-five JEV strains were isolated from a total of 11 650 mosquitoes. The identity of nucleotide appeared as 87.8%-99.7% both from 2012 to 2013 and from 1982 to 2010 while as 87.7%-88.0% with vaccine strain SA14-14-2, in Zhejiang. The phylogeny tree of E gene indicated that the newly isolated virus belonged to genotype I but no mutation of amino acid sequence coding conformational epitope was identified in the envelop protein. Both positive rates and the geometric mean titer (GMT) of neutralizing antibody in healthy people were 31.5%-42.0% and 1 : 2.56-1 : 3.53 in Xianju county, during 2012 and 2013, respectively. Both of the two positive rates (χ(2)≤1.76, P > 0.05) and the two GMTs (u≤0.64, P > 0.5) for antibodies pre or post the epidemic season did not show significant differences.

CONCLUSIONJEV isolated in Xianju during 2012 and 2013 belonged to genotype I. The positive rates of JEV neutralizing antibody from healthy people in Xianju were less than 42.0%, which showed no significant differendes pre or post JE epidemic season.

Amino Acid Sequence ; Animals ; Antibodies, Neutralizing ; blood ; Antibodies, Viral ; blood ; China ; Culicidae ; virology ; Disease Vectors ; Encephalitis Virus, Japanese ; genetics ; immunology ; isolation & purification ; Encephalitis, Japanese ; virology ; Epitopes ; Genotype ; Humans ; Neutralization Tests ; Phylogeny