Objective:This work presents the therapeutic advantage of induction therapy in patients withⅢA-N2 non-small cell lung cancer (ⅢA-N2 NSCLC). Methods:ⅢA-N2 NSCLC patients with ipsilateral mediastinal lymph node metastasis (>1 cm as shown by CT scan) who were admitted in our hospital between January 2008 and July 2013 were retrospectively analyzed. The response rates and survival outcomes of patients were presented and the prognostic factors were analyzed. Results:The 3-and 5-year overall survival (OS) rates were 57.7%and 34.2%, respectively, and the 3-and 5-year disease-free survival (DFS) rates were 37.9%and 30.5%, respec-tively. No significant differences in OS and DFS were observed between R0 and R1 resections (P=0.118; P=0.369), between groups who received neo-adjuvant chemo-radiotherapy and chemotherapy (P=0.771; P=0.953), between cases with and without clinical re-sponse (P=0.865;P=0.862), and among groups of different histological subtypes (P=0.685;P=0.208). However, patients with standard lobectomy or pathological nodal downstaging exhibited better OS (P=0.023 and P=0.024, respectively) and DFS (P=0.036 and P=0.025, respectively) than those who had extensive resections or persistent N2. Univariate analysis predicted better OS and DFS for both standard lobectomy and pathological nodal donwstaging. In addition, Cox multivariate analysis revealed that only pathological nodal downstaging could be considered as a favorable prognostic factor for DFS, while non-smoking and standard lobectomy are the corre-sponding variables for OS. Conclusion:Neo-adjuvant therapy with platinum-based doublet is feasible and useful in tumor and patho-logical nodal downstaging, which potentially improved resectability and survival rates in patients withⅢA-N2 NSCLC. Performing lo-bectomy or pathological nodal downstaging following induction therapy improved the patients' survival rate.

Objective To study the effect of stigma maydis aqueous extract(SMAE) on glucagon in type 2 diabetic rats.Methods Type 2 diabetic male Sprague-Dawley rat mode was induced by high-fat and high-sugar dietary feeds and low dose streptozotocin(STZ). After 8 weeks of treatment,levels of fasting blood glucose(FBG) and glucagon(Glu) in serum were respectively assayed.Immunohistocmical study was adopted to analyze the expression of glucagon in islet cells.Results Compared with model control group,SMAE of middle and high dose remarkably reduced the level of FBG and Glu(P

Objective: To analyze the influential factors of job burnout among psychiatrists.Methods: Psychiatirsts were evaluated by questionnaires.Results: In general,the job burnout of psychiatrists was very serious.There were significant differences in gender in burnout individual level;the person of 31-35 age was prone to job burnout,and the middle-aged staffs’ job burnout was comparatively in high level;There was significantly correlated show between psychiatrists job burnout level and social support.Besides,there was significantly correlated show between psychiatrists job burnout level and coping way.Conclusion: Psychiatrists Burnout is a high-risk population.To better enhance the stability of their profession,we need concern psychiatrists’mental health from the integrated perspective,and improve their level of social support constantly,and prevent occupational burnout from the perspective of medical education early.

Objective To study the expression and clinical significance of thyroid transcription factor-1 (TTF-1) in stage Ⅰ non-small cell lung cancer (NSCLC) after operation and to 1 investigate the values in identification of the prognosis of stage Ⅰ NSCLC.Methods The expression of TTF-1 in 129 specimens of stage Ⅰ NSCLC was detected by immunohistochemistry.Results The positive rate of TTF-1 in stage Ⅰ NSCLC was 64.3％.There were significant differences in TTF-1 expression rate among pathological subtypes (x2 =25.231,P ＜ 0.001),different ages (x2 =4.581,P =0.032),sex (x2 =4.900,P =0.027) and differentiation degrees(x2 =11.519,P =0.019).Univariate analysis suggested that in the stage Ⅰ NSCLC patients,the median disease-free survival and overall survival of those positive for TTF-1 expression were superior to those negative:38.9 months versus 27.8 months (P =0.023) and 64.10 months versus 50.68months (P =0.013).Cox regression analysis suggested that TTF-1 expression,tumor differentiation degrees were independent factors affecting the prognosis of stage Ⅰ NSCLC.Conclusion Patients with TTF-1 positive expression often had better survival.Positive expression of TTF-1 and differentiation degree of tumor were independent prognostic factors to affect the prognosis of NSCLC.

Objective To evaluate the the protectice effect of dexmedetomidine combined limb remote ischemic postcondition on alleviating focal cerebral ischemic reperfusion injury in rats .Methods 48 healthy adult male SD rats were randomly divided into 4 groups(n= 12) :control group(C) ,limb remote ischemic postcondition group(R) and dexmedetomidine postconditioning group(D) and combination group(R/D) .The rat model of focal cerebral ischemic reperfusion injury was induced by middle cerebral artery oc‐clusion(MCAO) .The group C only received MCAO ,the left femoral artery was isolated without blocking ;the group R received 120 min brain ischemia ,the left femoral artery was occluded by 3 cycles of 10 min occlusion/10 min reperfusion before brain reperfu‐sion ;the group D received dexmedetomidine 3 μg/kg by intraperitoneal injection before brain reperfusion .The group R/D combined the above two kinds of processing method .The neurologic function was evaluated at 24 h of reperfusion and then the rats were sac‐rificed at 48 h of reperfusion .The brain was removed for determining the cerebral infarct volume .Results The neurologic function scores after 24 h reperfusion in the group D ,R and R/D were superior to those in the group C (P< 0 .01) .The rat cerebral infarct volume percentages after 48 h reperfusion in the group D ,R and R/D were significantly lower than those in the group C ( P <0 .01) .The infarct area volume percentage in the group R/D was significantly lower than that in the group R ,the difference showed statitistical significance(P< 0 .01) .The infarct volume percentage in group R/D was significantly decreased compared with the group D(P< 0 .05) .Conclusion Both dexmedetomidine and limb remote ischemic postcondition can attenuate the focal cerebral is‐chemic reperfusion injury in rats .Their combination can significantly reduce the cerebral infarction volume and has synergic protec‐tion effect .

BACKGROUND: Bone marrow mesenchymal stem cell transplantation is superior to neural stem cell transplantation to repair spinal cord injury; however, the therapeutic effect is unstable and possibly related to microenvironment.OBJECTIVE: To study the differentiation of cultured in vitro bone marrow mesenchymal stem cells (BMSCs) into neurocytes by establishing a microenvironment and to observe differential expression of protein.DESIGN, TIME, AND SETTING: Observational contrast study was performed at the Laboratory of Neurobiology, Basic Medical College, Harbin Medical University from July 2005 to May 2007.MATERIALS: Adult Wistar rats and newborn fetal rats were used in this study.METHODS: Spinal cord was obtained from fetal rats to culture neurocytes. While, BMSCs were separated from bone marrow of adult rats, and they were then cultured in vitro, proliferated, and labeled with red fluorescin PKH26. BMSCs and neurocytes were individually cultured in the BMSCs group and the neurocyte group, respectively. In addition, BMSCs and neurocytes were co-cultured in vitro in double-layer culture dish in the co-culture group and the layered combination group, respectively.MAIN OUTCOME MEASURES: The obtained cells after 7-day culture were immunofluorescently detected by neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP). Surface enhanced laser desorption/ionization time of flight mass spectrometry (SELDI-TOF-MS) technique was used to analyze associated protein that was apparently changed during the differentiation from BMSCs into neurocytes.RESULTS: Seven days after co-culture, BMSCs were morphologically shared like neurocytes. Immunofluorescence indicated that NSE- and GFAP-positive ratios of BMSCs in the co-culture group were significantly higher than the layered combination group (P < 0.05); while, the ratios in the layered combination group were significantly higher than BMSCs alone group (P < 0.05). Five protein expressions were changed during the differentiation from BMSCs into neurocytes, for example, TIP39_RAT and CALC_RAT expressions increased in the layered combination group, which were 5.344 and 2.805 times as the primary expressions; INSL6_RAT, PNOC_RAT, and PCSKI_RAT expressions decreased, which were 0.380, 0.499, and 0.437 times as the primary expressions.CONCLUSION: By a microenvironment, both BMSCs and neurocytes in the co-culture and layered combination groups can differentiate into neuroblasts; while, contact differentiation ratio is higher than non-contract one. The differentiation is closely related to five proteins, including TIP39_RAT, CALC_RAT, INSL6_RAT, PNOC_RAT, and PCSK1_RAT.

The biological activities i. e. antineoplastic activities and antiviral activity of the two novel kinds of interferons: hIFN-λ1 and hIFN-ε were studied and compared. First the fusion expression vector: pcDNA3.1A-hIFN-λ1-His and pcDNA3.1A-hIFN-ε-His by PCR was constructed, then the two kinds of plasmids were transfected into WI-38 (human embryonic lung cells ) with liposome. And cytopathic effect (CPE) suppression test was used to study and compare the antiviral activities of rhIFNλ1-His and rhIFN-ε-His, meanwhile MTT assay was used to detect their antineoplastic activities. It was found that, antiproliferative activity and MxA protein induction shown by rhIFN-λ1-His is more powerful than of rhIFN-ε -His. The antiviral molecular mechanisms of both hIFN-λ1 and hIFN-ε are related to MxA. The foundation for further study on the bioactivities and mechanism of action of hIFN-λ1 and hIFN-ε was established.

Objective This study was to analyze the early and long-term effect of completion pneumonectomy.Methods Retrospective analysis was made on the patients who underwent completion pneummonectomy in Shanghai Chest Hospital.Results There were totally 56 cases patients underwent completion pneumonectomy during January 2003 to July 2013.Among them,45 patients received CCP,and other 11 patients received RCP.CCP refers to the complete removal of lung tissue remaining after an initial ipsilateral partial pulmonary resection.RCP refers to the complete removal of residual lung due to the severe complications after pneumonectomy.The mortality and morbidity rate of CCP were 4.4％ and 33.3％ respectively.In the case of CCP,the incidence of benign lesions is significantly higher than the incidence of malignant tumor(80.0％ vs 27.5％,P =0.04).The mortality and morbidity rate of RCP were 27.3％ and 90.9％ respectively.In the case of RCP,higher postoperative mortality often occurs in aged patients (P =0.046) and patients with preoperatie mechanical ventilation (P =0.03).Overall five-year survival rate for patients with benign lesions was 80％,and for malignant lung cancer patients,the number was 30％.Survival time differs according to the TNM staging(a median of 60.0 months,35.0 months,10.0 months,stage Ⅰ,stage Ⅱ,stage Ⅲ,P ＜0.01),and survival rate was higher when the time interval(between the initial pulmonary resection and the completion pneumonectomy) ＞ 2 years(a median of 60.0 months,18.0 months,P ＜ 0.01).Conclusion Completion pneumonectomy is a high-risk surgery,especially RCP.Advanced age and preoperative mechanical ventilation are associated with higher postoperative mortality rate for RCP.As for CCP,higher postoperative risk exists in patients with benign lesions,but the survival rate is also higher.In patients with malignant lung tumor,survival rate is higher when the time interval (between the initial pulmonary resection and the completion pneumonectomy) ＞2 year.

Objective Explore a new method which application absorbable suture netting for chest wall reconstruction and observe the clinical effect.Methods For 23 cases of part of the rib resection,support the soft tissue using absorbable suture netting and observe the postoperative results.Results 23 patients have the postoperative respiratory stability and no abnormal breathing and chest wall collapse happened.And this method has a good effect to support the Chest wall.Conclusion Chest wall reconstruction using absorbable suture netting has the following advantages:easily obtained,easy to learn to promote,low prices and postoperative respiratory stability.We believe this method is a new technology deserved to be promoted in our country.

Objective To investigate the effects of inhibitor of growth 5 (ING5) gene on the proliferation, apoptosis, migration and cell cycle of human breast cancer Bcap-37 cells.Methods The eukaryotic ING5-expressing plasmid and GFP-empty plasmid were steadily transfected in Bcap-37 cells, the expression of green fluorescent protein was measured with fluorescence microscopy, and the high expression of ING5 was measured by real time-PCR. Bcap-37-ING5 cells served as the experimental group, Bcap-37-GFP cells as the mock group and Bcap-37 as the control group. The effects of ING5 on the proliferation were detected by MTT, the cell cycle and apoptosis were detected by Flow cytometry, and the cell migration was detected by cell wound scratch assay and Transwell experiment.Results Bcap-37 cell lines steadily expressing ING5 protein with GFP-tag were acquired by stable transfection. ING5 over-expression inhibited the proliferation and led to G2 arrest of Bcap-37 cells, increased cells apoptosis and decreased the cell migration ability (P<0.05).Conclusion ING5 over-expression may have reverse effect for malignant phenotype of breast cancer cells, and may be employed to indicate the biomarker of prognosis of breast cancer patients and regarded as a target of gene therapy.