Objective To study the expression and significance of bcl-2 protein in esophageal squamous cell cancer and the surrounding tissues.Methods EnVision method was used to analyze the expression of bcl-2 protein in tissues of esophageal squamous cell cancer and the surrounding tissues from 62 patients.Results Expressions rates of bcl-2 protein were 80.3 ％ (49/61),45.9 ％ (28/61) and 67.7 ％ (20/62) in simple hyperplasia,high grade intraepithelial neoplasia and squamous cell carcinoma tissues,respectively,but 3.3 ％ (1/30) in normal mucosa tissue.There were significant differences between normal esophageal mucosa group and other groups (x2 =54.437,P ＜ 0.01).The expression of bcl-2 had no differentiation in tissue differentiation grade and degree of invasion of carcinoma (x2 =0.219,x2 =5.878,P ＞ 0.05).But it had significant relationship between the expression of bcl-2 and lymph node metastasis (x2 =4.120,P ＜ 0.05).Conclusion bcl-2 may predicting the occurrence of esophageal squamous cell cancer in early stage,and may be regarded as an useful index for prognosis.

Objective To investigate the diagnosis value of homocysteine (Hcy) combined with carcinoembryonic antigen (CEA) and squamous cell carcinoma (SCC) antigen for esophageal cancer.Methods The serum levels of Hcy,CEA,CA199,CA724,CA50 and SCC antigen in 163 patients with esophageal cancer and 49 healthy people were measured.The diagnosis efficacy between the combination of Hcy,CEA and SCC antigen and the combination of CEA,CA199,CA724,CA50 and SCC antigen was compared.Results The levels of Hcy,CEA and SCC antigen were significantly raised in patients group as compared with the levels in control group (all P ＜ 0.05).The area under the ROC curve of Hcy was 0.722 (95 ％ CI 0.633-0.811),CEA was 0.619 (95 ％ CI 0.533-0.704) and SCC antigen was 0.685 (95 ％ CI 0.608-0.762),respectively.There were no significant differences among the three area under the ROC curve.The sensitivity,specificity and accuracy of the combination of CEA,CA199,CA724,CA50,SCC antigen were 69.9 ％,59.2 ％ and 67.5 ％,respectively,but the sensitivity,specificity and accuracy of the combination of Hcy,CEA,SCC antigen were 96.3 ％,69.4 ％ and 90.1％,respectively.There was significant difference between the combination of Hcy,CEA,SCC antigen and the combination of CEA,CA199,CA724,CA50,SCC antigen (P ＜ 0.05).Conclusion The combination of Hcy,CEA,SCC antigen is helpful to determine the diagnosis and efficacy of esophageal cancer.

AIM: To investigate two single nucleotide polymorphisms (SNP) in the apolipoprotein(a) promoter at positions -418 and -384 and to compare distributing difference of genotype frequencies of single nucleotide among different races and to explore the influencies of them on serum lipid level and their association with coronary heart disease (CHD). METHODS: Using PCR-RFLP (BsgI,BfaI) method, we determined genotypes of these two SNPs in 156 unrelated healthy controls of HanZu Chinese and 56 unrelated CHD patients of HanZu Chinese and 56 unrelated African Blacks, then cloned polymerase chain reaction (PCR) products into T-vector and sequenced it by M13 currency primer, correspondingly. RESULTS: (1) There was no polymorphism at position -418A/A and -384C/C in control group. Only one CHD patient′s genotype determined was -418G/G, other were -418A/A and (-384C/C) in CHD patients. (2) Only two African Blacks′ genotype determined was -418G/G, other were -418A/A and (-384C/C) in African Blacks. (3) However, the Apo(a) promoter sequence was in coincident with the sequence publicized in GenBank and the base at positions -418 was adenine (A) and -384 was cytosine (C). CONCLUSION: The mutation frequencies at position -418 and -384 are low in the Chinese Han Population of Hubei and perhaps no single nucleotide polymorphisms is at two positions. No association with serum lipid levels and CHD is observed. There may be great variabilities to the SNPs in the Apo(a) promoter among different races.

Objective To study the expression of VEGF isoforms, COX-2 in esophageal cancer Methods VEGF, COX-2 mRNA expression in 40 paired samples (tumor and adjacent normal tissue) were determined by using real time RT-PCR. Results VEGF165 was overexpressed in 25 of 40(62.5 %) tumor tissues compared with in 6 of 40 (15 %) adjacent normal tissue; COX-2 was overexpressed in 28 of 40(70 %) tumor tissues compared with in 5 of 40(12.5 %) adjacent normal tissue. Conclusion This result suggests that VEGF165 and COX-2 overexpression in esophageal cancer.

Objective To observe the changes of abdominal oxygen saturation in very low birth weight infants (VLBWI)with feeding intolerance (FI)within 1 4 days after birth monitored by near infrared spectroscopy (NIRS).Methods VLBWI fitting entry criteria were enrolled into this study.NIRS monitoring was carried out to detect cerebral oxygen saturation (ScO2 )and abdominal oxygen saturation (SsO2 ).Data were analyzed between FI infants and feeding tolerance (FT)infants.FI was defined as follows:gastric residual of more than 50% of the previous feeding volume;emesis or abdominal distention or both;decrease,delay or discontinuation of enteral feedings. Results 93 VLBWI were enrolled.52 cases(55.91 %)presented with FI,including 29 cases(31 .1 9%)of gastric residual increasing and 23 cases(24.73%)of emesis with or without abdominal distention within 1 4 days after birth. The levels of SsO2 and SsO2 /ScO2 showed no differences in infants with FT and with FI within 24h after birth (P >0.05).The change rates of the median of SsO2 and SsO2 /ScO2 in FT infants were similar during 1 4 days (P >0.05).While both the change rates of SsO2 and SsO2 /ScO2 were markedly decreased 1 day before and the day of FI (P <0.01 ).The decreasing degree of SsO2 was similar between infants with gastric residual increasing and infants with emesis with or without abdominal distention[(1 6.2 ±5.1 )vs (1 7.4 ±3.6)%,t =0.733,P =0.476]. Conclusion Abdominal oxygen saturation measured by NIRS may be a useful method for infants adjusting the feeding plan.

Objective To investigate the expressions of p16, cyclinD1 protein in esophageal squamous cell carcinoma and its clinic significance. Methods The expressions of p16 and cyclinD1 protein in 55 esophageal carcinoma cases were detected by immunohistochemical technique. Results The positive expression of p16 protein in 55 patients was 49.1%(27/55). The loss of p16 protein was significantly related to lymph node metastasis (P ＜0.05), and the positive expression of p16 had the higher five-year survival rate.Conversely, the positive expression of cyclinD1 in 55 patients was 74.5 % (41/55), and had the lower five-year survival rate compared to the negative expression cases. Conclusion Loss of p16 protein in human ESCC is a frequent event and correlates significantly with the lymph node metastasis. The loss of p16 and the over expression of cyclinD 1 in esophageal carcinoma may serve as a risk prognosis factors.

Objective To investigate the role of cell cycle regulatory protein CDK4,p18,p19 in the genesis and development of esophageal squamous cell carcinoma (SCC).Methods Tissue microarray and immunohistochemical method (Envision) were used to detect the protein expression of CDK4,p18,p19 in 120 cases of esophageal tissues.The results were statistically analyzed.Results The positive rate of CDK4 protein expression in normal esophageal epithelium was low [28.3 % (34/120)],it increased in esophageal intraepithelial neoplasia [32.5 % (39/120)],and it was high in esophageal SCC [84.2 % (101/120)],which increased with the degree of SCC differentiation decreasing gradually.There was significant differences between the SCC and normal esophageal epithelium or esophageal intraepithelial neoplasia (x2= 76.004,P ＜0.05; x 2= 65.897,P ＜ 0.05).The expression of CDK4 in group with lymphatic metastasis [93.88 % (46/49)]was higher than without it [71.43 % (55/71)] (x2= 5.860,P ＜ 0.05).The positive rates of p18,p19 protein expression in normal esophageal epithelium were high [34.2 % (41/120),29.2 % (35/120)],it decreased in esophageal intraepithelial neoplasia [19.2 % (23/120),15.0 % (1 8/120)] (x 2= 134.481,P ＜ 0.05; x 2 = 141.376,P ＜ 0.05),but it were high in esophageal SCC [63.3 % (76/120) and 61.7 % (74/120)] which decreased with the degree of SCC differentiation gradually increased.There were significant differences between the normal esophageal epithelium and esophageal intraepithelial neoplasia,esophegeal intraepithelial neoplasia and SCC,normal esophageal epithelium and SCC (p 18:x 2 = 6.903,48.296,20.429,P ＜ 0.05; p1 9:x2 = 6.998,55.276,25.565,P＜ 0.05).CDK4 protein expression was correlated with both p18 and p19 (r =0.696,0.630,P ＜0.05),and there was significant positive correlation between the protein expression of p18 and p19 (r =0.833,P ＜0.05).Conclusion Cell cycle regulatory gene CDK4,p18,p19 get involved in the genesis and development of esophageal squamous cell carcinoma.Their protein expressions are closely related to canceration of esophageal epithelium.

Objective To investigate the difference of complication incidence, death rate, quantity of lymphadeneetomy, lymphatic metastasis rate and long-term survival rate in thoracic squamons cell carcinoma of esophagus between three fields lymphadenectomy (3-FL) and traditional method. Methods Homoehronous 96 esophageal cancer patients were fractionated in two groups, 46 patients for 3-FL, the other 50 patients for traditional method. Results The average quantity of lymphadenectomy was 39.28 pieces per patient in 3-FL, and was significantly higher than 13.30 pieces per patient in traditional method (P <0.01). The rate of metastatic lymphatic nodes was 73.91%(34/46) in 3-FL patients, significantly higher than38.00%(19/50) in traditional method patients. For incidence of postoperative complications, recurrent laryngeal nerve damage and respiratory complication in 3-FL patients was significantly higher than patients in traditional method (P <0.05). The chest fluid obviously inereasod in 3-FL patients than in traditional method patients. There was significant contrast in 3-year survival rate between 3-FL patients and traditional method patients. Conclusion The there fields lymphadenectomy expand scope of lymphdenectomy effectually, accurate the staging of thoracic esophageal carcinoma. At the same time, a lot of evidence was found in raising survival rate for 3-FL. Disadvantage of 3-FL was severe surgical trauma, high incidence of complication, and a long recovery time after operation.

Objective To analyze the alterations of serum protein in ESCC,compare alterations of serum protein with and without LM. Methods Serum samples were collected from 64 ESCC patients before operation and 60 cases with gender and age-matched healthy controls,special serum protein or peptide spectra was determined by SELDI-TOF-MS measurement after treating the sample onto weak cation exchange (WCX2) protein chip for each case. The serum protein profiles were compared by Biomarker Wizard Software between the ESCC patients and healthy controls, and among ESCC patients stratified according to gender, age, location of tumor, size of tumor, infiltration and with or without LM. Results (1)120 protein peaks were detected at the molecular range of 0 to 50000 in comparing of ESCC patients and healthy controls. 31 significantly different peaks were found between ESCC patients and healthy controls (P <0.05), 10 peaks were selected(P<0.01). (2) One significantly different protein peak (m/z 4174) was detected between T1 and T3, T4 (P<0.05). (3) There were three significantly different protein peaks (m/z 3970,4174 and 4277) between with LM and without LM (P<0.05).The peak (m/z 4174) was shared by two groups above. (4) No significant different protein was found when patients stratified according to gender, age, location of tumor and size of tumor. Conclusion Significant difference exists in serum proteins between ESCC patients and healthy controls. There are statistical difference exists in serum proteins between T1 and T3, T4, with LM and without LM. This difference is less than between ESCC patients and healthy controls. Some commonness is existed in serum protein fingerprint for patients with serious infiltration and with LM.

Objective: To explore the efficacy of thoracoscopic bronchial sleeve lobectomy for central non-small cell lung cancer (NSCLC), and to evaluate the safety of this operation. Methods: The clinical data of 29 patients who underwent thoracoscopic bronchial sleeve lobectomy at Shanxi Provincial Cancer Hospital from May 2015 to September 2018 were retrospectively analyzed, and the surgical effect and safety were analyzed. Results: Twenty-nine cases underwent thoracoscopic bronchial sleeve lobectomy. The types of resection included 13 cases of right upper, 10 cases of left upper, and 6 cases of left lower sleeve lobectomy. The operation time was 180-400 min, and the median time was 240 min. The bronchial anastomosis time was 35-60 min, and the median time was 48 min. The intraoperative blood loss was 150-460 ml, and the median blood loss was 220 ml. The number of lymph node dissection was 12-39 lymph nodes per patient, with a median of 19.6 lymph nodes per patient. The thoracic drainage tube was placed for 4-16 days after operation, with a median of 6 days; the postoperative hospital stay was 6-16 days, with a median of 9 days. The postoperative complication rate was 24.1% (7/29), including 1 case with pulmonary air leakage (> 7 days), 2 cases with pulmonary infections, 3 cases with arrhythmia, and 1 patient discharged from the hospital on the 7th day after surgery, but died of anastomotic fistula bleeding on the 40th day. The rest of the patients recovered smoothly after surgery. The median follow-up time was 6 months (3-12 months). No tumor recurrence or anastomotic stenosis was observed. Conclusion Thoracoscopic bronchial sleeve lobectomy is a safe and feasible surgical treatment for central NSCLC.