Objective To understand the relationship between GATA -4,-5,-6 gene mutations and con-genital heart disease(CHD),and to provide grounds for early prevention and genetic counseling of children with CHD. Methods GATA -4,-5,-6 coding regions exons and the flanking intron sequences in 1 98 CHD patients were screened,including 66 cases of the ventricular septal defects,84 cases of the atrial septal defects,and 48 cases of the nonsyndromic conotruncal heart defects patients.A total of 300 healthy subjects were selected as controls.The acquired sequences were aligned with which those publicized in GenBank by the aid of program BLAST.All exons and bilateral partial intron -exon boundaries of GATA -4,-5,-6 genes were amplified by the polymerase chain reaction (PCR). The PCR products were purified and directly sequenced by automatic DNA sequence equipment.The acquired GATA -4,-5,-6 gene sequences were compared with GenBank standard gene sequences with the aid of program BLAST. Results A heterozygous missense mutation in the GATA -4 gene was identified in a ventricular septal defect patient and a persistent truncus arteriosus patient.The mutation was located in c.799G >A(p.V267M)in exon 4 of GATA -4. Multiple aligenment of GATA -4 proteins across species demonstrated that altered amino acid was highly conserved. Transcription factor GATA -5,-6 screening showed no mutations in children with CHD in this study.Conclusions Transcription factor GATA -4 gene mutation may be associated with the occurrence of CHD.Transcription factor GATA -4 gene may be susceptible gene in human CHD.

The classification of lung tumor with the help of computer-aided diagnosis system is very important for the early diagnosis and treatment of malignant lung tumors. At present, the main research direction of lung tumor classification is the model fusion technology based on deep learning, which classifies the multiple fusion data of lung tumor with the help of radiomics. This paper summarizes the commonly used research algorithms for lung tumor classification, introduces concepts and technologies of machine learning, radiomics, deep learning and multiple data fusion, points out the existing problems and difficulties in the field of lung tumor classification, and looks forward to the development prospect and future research direction of lung tumor classification.

Objective To compare the clinical effects between uniportal video-assisted thoracic surgery (VATS) and 3-portal VATS lobectomy for patients with lung cancer. Methods Patients were divided into uniportal VATS lobectomy group (n=45) and 3-portal VATS lobectomy group (n=53). The clinical data were compared between two groups, including the oper-ation time, intraoperative blood loss, number of lymph node dissection, length of incision, postoperative extubation time, post-operative pain score and postoperative hospitalization. Results There were no significant differences in intraoperative blood lose (128.75±18.32) mL vs (129.15±17.69) mL, lymph node dissection number (13.33±1.05) vs (13.12±1.38), duration of chest drainage (4.90±0.75)d vs (4.75±0.70)d, duration of hospital stay (7.52±1.16)d vs (7.55±1.10)d and incidence of seri-ous postoperative complications between two groups (P>0.05). The incision length (5.36±0.22)cm vs (7.44±0.35)cm, numeric pain intensity scale including first day(6.47±0.54) vs (6.86±0.52),third day(3.59±0.29) vs (4.05±0.25), and patient satisfac-tion scores (91.03 ± 2.62) vs (88.35 ± 2.97) were significantly better in uniportal VATS group than those of 3-portal VATS group (P<0.05). The operation time (143.81±17.97) min vs(130.11±15.03)min was longer in uniportal VATS group than that of 3-portal VATS group (P < 0.05). Conclusion Uniportal VATS lobectomy is safe and reliable for patients with early-stage lung cancer, which has less surgical injury, slighter pain, and higher satisfaction than 3-portal VATS lobectomy.

Objective To investigate the expression levels and clinical significance of (forkhead box Q1) FOXQ1 and E-cadherin in esophageal squamous cell carcinoma (ESCC). Methods Expression levels of FOXQ1 and E-cadherin were in ESCC tissues (ESCC group, n=42) and adjacent normal esophageal tissues (control group, n=42) were detected using im?munohistochemistry. Correlations of FOXQ1 and E-cadherin expressions with clinical pathological parameters and progno?sis were analyzed between two groups. Results The expression level of FOXQ1 was significantly higher in ESCC group than that in control group(64.29% vs 28.57%,χ2=5.384,P<0.05). The expression level of E-cadherin was significantly lower in ESCC group than that incontrol group(52.38%vs 90.48%,χ2=7.691,P<0.05). There were significant differences in FOXQ1 expressions between different TNM stages and whether lymph node metastasis is involved within ESCC group. There were significant differences in expression of E-cadherin between different tumor differentiation, depth of invasion, TNM stage and whether lymph node metastasis is involved within ESCC group. The expression of FOXQ1 was negatively cor?related with E-cadherin in ESCC (r=-0.412, P<0.05). The 5-year survival rates were significantly lower with high expres?sion of FOXQ1 or with low expression of FOXQ1(18.52%vs 66.67%,χ2=9.737,P<0.05). The 5-year survival rates were significantly higher with high expression of E-cadherinor low expression of E-cadherin(59.09%vs 10.00%,χ2=10.996,P<0.05). A multivariate Cox's proportional hazard regression analysis indicated that high FOXQ1 expression, low E-cadherin expression and lymph node metastasis were independent prognostic factors for ESCC. Conclusion The expression of FOXQ1 and E-cadherin showed a good correlation with ESCC. And examining expressions of both FOXQ1 and E-cadherin in ESCC may have practical values in estimating the prognosis of ESCC and directing future treatment .

Objective To evaluate the effect of curing achalasia by transabdominally Heller-Dor operation. Methods To summarize 33 cases of achalasia treated by transabdominally Heller-Dor procedure and visit them postoperatvely. 18 patients receive pre- and post-operativemanometry and 24-hour-pH monitoring. The parameters including reflux frequency 、the longest lasting-time of reflux 、the total time(min) of pH ＜4.0 and the percentage( % ) of time of pH ＜4.0 were recorded and compared using statistical mothods. Results Symptom was significantly improved in 32 patients after surgery, while 1 patient remained dysphasia as pre-operative. The LESP, the reflux frequency、the longest lasting-time of reflux 、the total time(min) of pH ＜ 4.0 and the percentage ( % ) of time of pH ＜ 4.0 also declined after operations ( P ＜ 0. 05 ). 30 patients were followed up,22 (73.3% ,22/30) were cured and 8 had mild sypmtom. Reflux did not detected in 3 cases( 16.7% ,3/18 ) with preoperative reflux. Conclusion Transabdominally Heller-Dor operation could dramadically alleviate the symptoms of patients with achalasia, moreover, it could especially prevent the postoperative-reflux, and with the advantages of simple operations, little traumas.

Objective To study l-arginine aerosolized inhalation's protective effect on pulmonary ventilation of the pulmonary-arterial-hypertension patients during the early stage after pulmonary lobectomy,and its preventive effect on reducing postoperative complications.Methods 54 cases of pulmonary lobectomy patients with preoperative plumonary arterial hypertension were divided into two groups randomly-Group A was given L-arginine aerosolized inhalation within 4 h after the operation;Group B was given the same dose of aerosolized inhalation of physiological saline as contrast(other postoperative medication being the same with Group A).Compare the two groups of patients in terms of oxygenation index(PaO2/FiO2),alveolararterial oxygen difference(PA-aO2),nitric oxide(NO) concentration,ultrasonic cardiogram,mechanical ventilation duration,ICU duration,occurances of hemodvnamic disturbance and arrhythmia,and differences in postoperative hospital stay.Results The oxgenation index and the content of NO in plasma of Group A were higher than that of Group B(P ＜0.001);the alveolar-arterial oxygen difference and the postoperative pulmonary arterial pressure detected by UCG of Group A were lower than that of Group B(P ＜ 0.001);the postoperative mechanical ventilation duration,ICU duration,occurances of hemodynamic disturbance and arrhythmia of Group A were all lower than that of Croup B(P ＜ 0.05).Conclusion The postoperative l-arginine aerosolized inhalation during the early stage after pulmonary lobectomy has positive effect on the lung protection of the pulmonary-arterial-hypertension patients and it can reduce the perioperative complications and postoperative hospital stay of such patients.

OBJECTIVETo investigate the chemical constituents from the whole plants of Senecio chrysanthemoides.

METHODConstituents were isolated by using a combination of various chromatographic techniques including column chromatography over silica gel, Sephadex LH-20, and ODS C18, as well as reversed-phase HPLC. Structures of the isolates were identified by spectroscopic and chemical methods.

RESULTEighteen glycosides were obtained from a H2O-soluble portion of an ethanolic extract of the whole plants of Senecio chrysanthemoides and their structures were elucidated as 5'-methoxyligusinenoside B (1), hyuganoside III b (2), citrusin A (3), alaschanioside A (4), citrusin B (5), dehydrodieoniferyl alcohol 4, gamma'-di-O-beta-D-glucopyranoside (6), osmanthuside G (7), syringin (8), dehydrosyringin (9), 2-(4-hydroxy-3,5-dimethoxyphenyl) ethanol 4-O-beta-D-glucopyranoside (10), 2-phenylethyl beta-gentiobioside (11), phenethyl beta-D-glucopyranoside (12), nikoenoside (13), benzyl beta-D-glucopyranoyl (1 --> 6 ) -beta-D-glucopyranoside (14), 3,5-dimethoxy-4-hydroxybenzyl alcohol 4-O-beta-D-glucopyranoside (15), icariside B2 (16), sonchuionoside C (17), and 1-[(beta-D-glucopyranosyloxy) methyl] -5,6-dihydropyrrolizin-7-one (18).

CONCLUSIONCompound 1 was a new lignan glycoside, and the remaining compounds were obtained from this plant for the first time.

Chromatography ; methods ; Glycosides ; chemistry ; isolation & purification ; Lignans ; chemistry ; isolation & purification ; Plant Extracts ; chemistry ; Plants, Medicinal ; chemistry ; Senecio ; chemistry

Objective: To explore the molecular and genetic mechanism of transcription factor GATA-6 in nonsyndromic conotruncal defect (CTD) in order to provide evidence for early prevention and inheritance consultation of CTD. Methods: A total of 32 cases of patients with nonsyndromic CTD and 100 healthy individuals were enrolled in the study.A total of 7 exons and bilateral partial intron-exon boundaries of GATA-6 were amplified by means of polymerase chain reaction (PCR). The PCR products were purified and directly sequenced by using an ABI Genetic Analyzer 3100 Automatic DNA sequence equipment.The acquired GATA-6 gene sequence was compared with standard gene sequence published in National Center for Biotechnology Information database, as well as the healthy control group to observe the GATA-6 gene mutations.The mutations were introduced into pcDNA3.1(+ ) by site-directed mutagenesis PCR on the basis of pcDNA3.1(+ )-GATA-6 in order to generate the GATA6-G245R mutant constructs.Wild type GATA-6, GATA-6-G245R and atrial natriuretic factor-luciferase(ANF-luciferase) were cotransfected into HEK 293T cells in vitro, and the CMV-LacZ were cotransfected as internal reference.Luciferase and galactosidase activity were measured by using luminometer 24 h after transfection and detected in the downstream ANF-luciferase reporter gene. Results: A heterozygous missense mutation in the GATA-6 gene was identified in a patient with double outlets of the right ventricle.The mutation was located in Gly245Arg(G245R) in exon 2 of GATA-6.The mutation of pcDNA3.1(+ )-GATA-6 expression vectors were successfully constructed.Through the detection of luciferase reporter gene activity, it was found that GATA-6-G245R and wild-type GATA-6 decreased by 41.3%, and the comparison between them was statistically significant (P<0.001). Conclusions Transcription factor GATA-6 gene mutation is associated with the occurrence of nonsyndromic CTD.Transcription factor GATA-6 gene may be susceptible gene in human nonsyndromic CTD.

Objective The mechanism of the lymph node metastasis in lung adenocarcinoma is unknown.The characteristic of the N1 and N2 lymph nodes metastasis are different.We explore the relationship between the N1 lymph node metastasis and clinicopathological factors in lung adenocarcinoma patients.Methods Data of 126 patients who had received lobectomy and systematic lymph node dissection were retrospectively analyzed.Chi-square test and Fisher exact method was used in univariate analysis,logistic regression was performed to analyze the multivariate analysis.Critical value was calculate in ROC.All the methods executed in software SPSS 19.0.Results After analyzed the N1 lymph node metastasis and clinicopathological factors,sex (P =0.016),diameter of tumor (P =0.001),pleural invasion (P =0.008),micropapillary pattern (P =0.028),solid pattern (P =0.047) has statistical significance in univariate analysis.Logistic regression analysis reveal diameter of tumor,micropapillary pattern and solid pattern were independent risk factors for N1 lymph nodes.CEA level (P =0.004),cancer embolus (P =0.029),micropapillary pattern (P =0.018),affect the groups (number of metastasis station) of the metastasis lymph nodes.Logistic regression analysis find CEA and micropapillary pattern were independent risk factors,which might lead multiple groups lymph nodes metastasis.There is only one factor could impact the location of the N1 lymph node metastasis,which is micropapillary pattern (P =0.027).Conclusion Via ROC results,there are three factors affect the N1 lymph nodes metastasis:purity of micropapillary pattern more than 27.5％,purity of solid pattern more than 15％,diameter of tumor larger than 3.0 cm.If a lung adenocarcinoma patient who was in early stage has one or more than one factors,we suggest chemotherapy followed the surgery.Higher CEA level or higher content of micropapillary pattern much more groups lymph nodes metastasis might appear,so radiotherapy and other method should be considered to added on.High content of micropapillary pattern maybe imply cancer cell has already invaded extra pulmonary lymph nodes.

BACKGROUNDTo explore the perioperative changes of T subsets and NK cell and analyze the related factors in patients with lung cancer.

METHODSThe T subsets and NK cell from peripheral blood of 60 patients with lung cancer, 15 patients with lung benign tumor and 15 healthy people were detected by immunofluorescence. These indexes of the patients with lung cancer were detected also at postoperative 2nd, 7th, 14th and 28th days.

RESULTS1.There were significant differences in the indexes between the lung cancer group and the groups of lung benign tumor and normal people except for CD8+ (P < 0.05). 2.At postoperative 2nd day CD3+, CD4+, CD4+/CD8+ and NK cell of the patients with lung cancer were decreased and CD8+ was increased significantly than those before operation (P < 0.05). During postoperative 1 to 2 weeks, all indexes had recovered basically to the preoperative level. At postoperative 28th day, CD3+, CD4+ , CD4+/CD8+ and NK cell were increased and CD8+ was decreased than those before operation (P < 0.05). 3. There was significant difference in the indexes among preoperative stage IIIA, IIIB and IB, and between preoperative N2 diseases and N0 group (P < 0.05). There was significant difference between the groups of radical and palliative operation and the group of thoracic exploration at postoperative 28th day (P < 0.05). There was significant difference in T subsets between the groups of blood transfusion and non-transfusion at postoperative 14th day (P < 0.05).

CONCLUSIONSThe cellular immune function of the patients with lung cancer was lower than that of the patients with lung benign tumor and normal people. The perioperative immunity of patients with lung cancer decreases after operation and increases later. TNM stage and lymph node metastasis are relative to preoperative but not postoperative immunity. There is no significant correlation between cellular immune function and pathological type of the tumor. Radical and palliative operations can both significantly increase the patients' cellular immune function. Therefore the palliative operation is better than thoracic exploration. Blood transfusion can depress the immune function of the patients, so it is better to avoid perioperative blood transfusion.